Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 017672 | GA |
NPI | 1003980848 |
---|---|
Provider Name | Dr. Richard Hendry Armond III |
First Address | Lilburn, GA 30047-2815 |
Second Address | Lilburn, GA 30047-2815 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E53972 | (02) | GA |