Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 038930 | GA |
NPI | 1760401756 |
---|---|
Provider Name | Dr. Kimberlynn R Richards |
First Address | Atlanta, GA 30331-8450 |
Second Address | Smyrna, GA 30082-5184 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 20/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F60764 | (02) | MD |