MEDICARE: DR. RICHARD C TARVERS MD

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
1	207L00000X	Anesthesiology Physician	37410	TN
2	207L00000X	Anesthesiology Physician	77215	GA

Other Identifiers

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

General Provider Information

NPI Number	:	1992703136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD C TARVERS MD

Provider Business Mailing Address
First Line	:	380 HOSPITAL DR
Second Line	:	STE 410
City	:	MACON
State	:	GA
Zip	:	31217-8014
Country	:	US
Telephone Number	:	865-546-8040
Fax Number	:	865-541-2787

Provider Business Practice Location Address
First Line	:	777 HEMLOCK ST
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31201-2102
Country	:	US
Telephone Number	:	478-331-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	04/13/2023

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Directions to “ DR. RICHARD C TARVERS MD” Practice Location

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