Individual
DR. RICHARD RANDALL RICKETTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1975 CENTURY BLVD NE, SUITE 6, ATLANTA, GA 30345-3316
(404) 982-9938
(404) 982-9136
Mailing address
3287 ALTON RD, ATLANTA, GA 30341-4305
(770) 452-8817
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
021580
GA
Other
Enumeration date
10/01/2006
Last updated
07/08/2007
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