Individual
E RICHARD GROVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
800 GORDON AVE, THOMASVILLE, GA 31792-6611
(229) 226-1338
(229) 226-4888
Mailing address
800 GORDON AVE, THOMASVILLE, GA 31792-6611
(229) 226-1338
(229) 226-4888
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
PO1679
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD000551
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000368013A
—
GA
01
—
0509810001
MEDICARE NSC
GA
01
—
480028811
RAILROAD MEDICARE
GA
Enumeration date
08/21/2006
Last updated
08/12/2008
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