Individual
MR. RICHARD G PETIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
748 OLD NORCROSS RD, SUITE 185, LAWRENCEVILLE, GA 30045-3393
(770) 277-8554
(770) 277-1799
Mailing address
748 OLD NORCROSS RD, SUITE 185, LAWRENCEVILLE, GA 30045-3393
(770) 277-8554
(770) 277-1799
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001435
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
863192094A
—
GA
Enumeration date
09/15/2006
Last updated
05/28/2008
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