Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 065941 | GA |
N | 207RP1001X | Pulmonary Disease | 65941 | GA |
NPI | 1063542280 |
---|---|
Provider Name | Ryan P Carrick |
First Address | Austell, GA 30106 |
Second Address | Austell, GA 30106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 12/11/2015 |