Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 049073 | GA |
N | 208000000X | Pediatrician | 049073 | GA |
NPI | 1851516769 |
---|---|
Provider Name | Dr. Richard Olney |
First Address | Decatur, GA 30033-5307 |
Second Address | Decatur, GA 30033-5307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 13/12/2007 |