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NPI Code Detail

MEDICARE: F. RICHARD BLUE PHD

MEDICARE: F. RICHARD BLUE PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist515GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083989479
Entity Type Code : Organization
Provider Name (Legal Business Name) : F. RICHARD BLUE PHD
Provider Business Mailing Address
First Line : 6100 LAKE FORREST DR NW STE 510
Second Line :
City : ATLANTA
State : GA
Zip : 30328-3837
Country : US
Telephone Number : 404-705-9770
Fax Number : 404-531-0517
Provider Business Practice Location Address
First Line : 6100 LAKE FORREST DR NW STE 510
Second Line :
City : ATLANTA
State : GA
Zip : 30328-3837
Country : US
Telephone Number : 404-705-9770
Fax Number : 404-531-0517
Authorized Official
Title or Position : PSYCHOLOGIST
Name : F. RICHARD BLUE
Credential :
Telephone Number : 404-705-9770
Provider Enumeration Date : 03/19/2012
Last Update Date : 03/19/2012

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