Individual
DR. RICHARD PEELE JAMES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
510 E OGLETHORPE HWY, HINESVILLE, GA 31313-2825
(912) 369-7546
(478) 274-8418
Mailing address
2400 BELLEVUE RD, SUITE 21-A, DUBLIN, GA 31021-2885
(478) 275-7202
(478) 274-8418
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
049455
GA
207ND0101X
MOHS-Micrographic Surgery Physician
049455
GA
207ND0900X
Dermatopathology Physician
049455
GA
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
049455
GA
207NP0225X
Pediatric Dermatology Physician
049455
GA
207NS0135X
Procedural Dermatology Physician
049455
GA
208D00000X
General Practice Physician
049455
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
049455
GEORGIA LICENSE
GA
01
—
11722501
CAQH
GA
05
—
667826146
—
GA
01
—
P00479722
RR MEDICARE
GA
Enumeration date
08/09/2006
Last updated
04/23/2015
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