Individual provider · NPI-1
Dr. Richard Harris Jadick, DO
Urology · Lagrange, GA
NPI number1083837975
StatusActive
Last updated in NPPESApr 26, 2024
Details
- NPI
- 1083837975
- Entity type
- Individual (NPI-1)
- Name
- Dr. Richard Harris Jadick
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 10, 2007
- Certification date
- Apr 26, 2024
- Last updated
- Apr 26, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208800000X | Urology | 069823 | GA | Yes |
Practice location
1555 Doctors Dr Ste 101Lagrange, GA 30240-4132
Phone 706-803-7540 · Fax 706-803-8816
Mailing address
1555 Doctors Dr Ste 101Lagrange, GA 30240-4132
Phone 706-803-7540 · Fax 706-803-8816
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