Bartley R. Richards, Do Pc | |
1654 Washington St Jefferson GA 30549-2666 | |
(706) 367-5006 | |
(706) 367-7711 |
Full Name | Bartley R. Richards, Do Pc |
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Speciality | Clinic/Center |
Location | 1654 Washington St, Jefferson, Georgia |
Authorized Official Name and Position | Bartley Ruark Richards (CEO) |
Authorized Official Contact | 7063675006 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bartley R. Richards, Do Pc 1654 Washington St Jefferson GA 30549-2666 Ph: (706) 367-5006 | Bartley R. Richards, Do Pc 1654 Washington St Jefferson GA 30549-2666 Ph: (706) 367-5006 |
NPI Number | 1023230620 |
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Provider Enumeration Date | 05/03/2007 |
Last Update Date | 06/24/2013 |
Medicare PECOS PAC ID | 0840250833 |
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Medicare Enrollment ID | O20041014000050 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023230620 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 033883 (Georgia) | Primary |
Provider Name | Bartley R Richards |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508962911 PECOS PAC ID: 3577524909 Enrollment ID: I20041020000157 |
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