Organization
NETWORK MEDICAL PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE RICHEY (BUSINESS OFFICE MANAGER)
(404) 501-7925
Entity
Organization
Contact information
Practice address
450 N CANDLER ST, 6TH FLOOR, DECATUR, GA 30030-2626
(404) 501-7925
(404) 501-6638
Mailing address
PO BOX 102846, ATLANTA, GA 30368-2846
(404) 501-7925
(404) 501-6638
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC3738
RR MEDICARE GROUP
—
Enumeration date
08/17/2006
Last updated
11/27/2007
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