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Individual

DR. RICHARD PROKESCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6285 GARDEN WALK BLVD, STE A, RIVERDALE, GA 30274-2612
(770) 991-1150
(770) 991-9047
Mailing address
6285 GARDEN WALK BLVD, STE A, RIVERDALE, GA 30274-2612
(770) 991-1150
(770) 991-9047

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
019754
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00159057A
GA
Enumeration date
07/31/2006
Last updated
09/15/2008
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