Individual
JINNE NIKI RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2402 OSLER CT, ALBANY, GA 31707-0205
(229) 438-3300
(229) 438-3384
Mailing address
2402 OSLER CT, ALBANY, GA 31707-0205
(229) 438-3300
(229) 438-3384
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
072428
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003148501A
—
GA
01
—
072428
GEORGIA MEDICAL LICENSE
GA
Enumeration date
07/11/2014
Last updated
08/01/2014
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