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Individual
RICKY STEVEN GARLAND
Active
Individual
RICKY STEVEN GARLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004080
GA
363AS0400X
Surgical Physician Assistant
004080
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01184192
AMERIGROUP
GA
05
—
0584PA
—
SC
01
—
582203199-004
TRICARE AFFILIATION
—
01
—
582203199-009
TRICARE AFFILIATION
—
05
—
873868589B
—
GA
05
—
873868589D
—
GA
05
—
873868589E
—
GA
05
—
873868589F
—
GA
05
—
873868589J
—
GA
05
—
873868589K
—
GA
01
—
P00477553
RR MEDICARE
GA
Enumeration date
10/20/2006
Last updated
03/17/2018
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