Individual
DR. RICHARD C LODISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
405 ARROWHEAD BLVD, SUITE C, JONESBORO, GA 30236-1254
(770) 478-9877
Mailing address
1780 W WESLEY RD NW, ATLANTA, GA 30327-1910
(404) 355-2130
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
030699
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00447851A
—
GA
01
—
050030324
RAILROAD MEDICARE
GA
Enumeration date
11/02/2005
Last updated
05/06/2010
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