Kimberlynn R. Richards, Md, Pc | |
4015 S Cobb Dr Se Suite 220 Smyrna GA 30080-6303 | |
(770) 801-0980 | |
(770) 801-9039 |
Full Name | Kimberlynn R. Richards, Md, Pc |
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Speciality | Clinic/Center |
Location | 4015 S Cobb Dr Se, Smyrna, Georgia |
Authorized Official Name and Position | Kimberlynn Rochelle Richards (OWNER) |
Authorized Official Contact | 4042721724 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kimberlynn R. Richards, Md, Pc 1865 Lyon Ave Sw Atlanta GA 30331-8450 Ph: (404) 272-1742 | Kimberlynn R. Richards, Md, Pc 4015 S Cobb Dr Se Suite 220 Smyrna GA 30080-6303 Ph: (770) 801-0980 |
NPI Number | 1316277858 |
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Provider Enumeration Date | 01/06/2010 |
Last Update Date | 10/03/2011 |
Medicare PECOS PAC ID | 5799826871 |
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Medicare Enrollment ID | O20100112000300 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316277858 | NPI | - | NPPES |
000625567J | Medicaid | GA | |
10171962 | Other | BIRTHDAY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 038930 (Georgia) | Primary |
Provider Name | Kimberlynn R Richards |
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Provider Type | Practitioner - Addiction Medicine |
Provider Identifiers | NPI Number: 1760401756 PECOS PAC ID: 3375549686 Enrollment ID: I20061010000454 |
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