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Individual

MR. RICHARD JOHN LIOTTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O

Contact information

Practice address
4585 NELSON BROGDON BLVD, SUGARHILL, GA 30518-3466
(770) 932-0547
(770) 932-4035
Mailing address
4585 NELSON BROGDON BLVD, SUGARHILL, GA 30518-3466
(770) 932-0547
(770) 932-4035

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036408
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000656576B
GA
01
0100402
UNITED HEALTHCARE
GA
01
0880369013
CIGNA HEALTHCARE
GA
01
4607419
AETNA MANAGED CARE
GA
01
513138
AETNA HMO
GA
01
752850
BLUE CROSS BLUE SHIELD
GA
Enumeration date
05/11/2006
Last updated
03/18/2010
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