Mr Jerry Rider, PA-C in Air Force Academy, CO - Physician Assistant

Mr Jerry Rider, PA-C is a Physician Assistant - Surgical based in Air Force Academy, Colorado. Mr Jerry Rider is licensed to practice in Tennessee (license number 2594) and his current practice location is 10th Medical Group/sghc, 4102 Pinion Dr, Air Force Academy, Colorado. He can be reached at his office (for appointments etc.) via phone at (719) 684-3159.

NPI number for Mr Jerry Rider is 1194884494 and his current mailing address is 10th Medical Group/sghc, 4102 Pinion Dr, Air Force Academy, Colorado. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1194884494.

Contact Information

	Mr Jerry Rider, PA-C
	10th Medical Group/sghc, 4102 Pinion Dr, Air Force Academy, CO 80840
	(719) 684-3159
	Not Available

Provider's Profile

Full Name	Mr Jerry Rider
Gender	Male
Speciality	Physician Assistant - Surgical
Location	10th Medical Group/sghc, Air Force Academy, Colorado
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1194884494
Provider Enumeration Date: 12/06/2006
Last Update Date: 03/20/2023

Medical Identifiers

Medical identifiers for Mr Jerry Rider such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1194884494	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363AS0400X	Physician Assistant - Surgical	(* (Not Available))	Secondary
363AS0400X	Physician Assistant - Surgical	2594 (Tennessee)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jerry Rider is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Jerry Rider, PA-C 10th Medical Group/sghc, 4102 Pinion Dr, Air Force Academy, CO 80840 Ph: (719) 684-3159	Mr Jerry Rider, PA-C 10th Medical Group/sghc, 4102 Pinion Dr, Air Force Academy, CO 80840 Ph: (719) 684-3159

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Mr Jerry Rider, PA-C - Physician Assistant in Air Force Academy, CO