Individual
DR. RICHARD LYLE BRANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
202 LAKESHORE DR, SUITE A, SAINT MARYS, GA 31558
(912) 673-1771
(912) 673-1811
Mailing address
202 LAKESHORE DR, SUITE A, SAINT MARYS, GA 31558
(912) 673-1771
(912) 673-1811
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
014890
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00379904A
—
GA
Enumeration date
06/20/2006
Last updated
02/25/2009
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