Individual
RICHARD L INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1602 VERNON RD, STE 400, LAGRANGE, GA 30240-4100
(706) 882-9341
(706) 884-0131
Mailing address
1602 VERNON RD, STE 400, LAGRANGE, GA 30240-4100
(706) 882-9341
(706) 884-0131
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
026563
GA
207RN0300X
Nephrology Physician
026563
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00291024A
—
GA
05
—
00291024C
—
GA
Enumeration date
06/08/2005
Last updated
04/15/2024
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