Individual
RICHARD RALSTON WHITLOCK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1348 WALTON WAY, SUITE 5100, AUGUSTA, GA 30901-5104
(706) 724-8611
(706) 724-6202
Mailing address
1348 WALTON WAY, SUITE 5100, AUGUSTA, GA 30901-5104
(706) 724-8611
(706) 724-6202
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
020623
GA
207RC0000X
Cardiovascular Disease Physician
7340
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00179077D
—
GA
01
—
1585885-004
CIGNA
GA
01
—
4134155
AETNA PPO
—
01
—
595429
BCBS
GA
01
—
897824
AETNA HMO
—
05
—
G20623
—
SC
Enumeration date
07/26/2006
Last updated
02/28/2019
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