Organization
LAKE OCONEE URGENT AND SPECIALTY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDDIE RICHARDSON M.D. (PHYSICIAN/PRACTICE OWNER)
(706) 484-0884
Entity
Organization
Contact information
Practice address
105 HARMONY XING, SUITE 3, EATONTON, GA 31024-9522
(706) 484-0884
Mailing address
1881 LANCASTER DR SE, CONYERS, GA 30013-6440
(404) 405-7596
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
7235
GA
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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