Kortrey, Richard A

Kortrey, Richard A is an individual health care provider with primary practice located at 777 Hemlock St , Macon GA 31201-2102. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant, which is considered as his primary health care specialty. Kortrey, Richard A can be contacted via phone (866) 507-5244.

Contact Information

Primary practice address
777 Hemlock St Macon GA 31201-2102
Phone: (866) 507-5244
Fax: (855) 851-4405
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X 2343 Georgia

Profile Details

NPI number 1992926703
LBN Legal business name Kortrey, Richard A
Credentials PA-AA
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2007
Last updated Aug 15th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992926703 NPPES
Georgia Other 100000476A PEACHSTATE CMO - MCCG
Georgia MEDICAID 100000476A PEACHSTATE CMO - MCCG
Georgia Other 344347 PEACHSTATE CMO - MCCG
Georgia Other 430052725 PEACHSTATE CMO - MCCG

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