Healthcare Provider Details

I. General information

NPI: 1629047766
Provider Name (Legal Business Name): RICHARD STUART EPTER M.D.,DABPM,FIPP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 04/23/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 INTERSTATE PKWY
AUGUSTA GA
30909-5626
US

IV. Provider business mailing address

1321 INTERSTATE PKWY
AUGUSTA GA
30909-5626
US

V. Phone/Fax

Practice location:
  • Phone: 706-738-7246
  • Fax: 706-922-9267
Mailing address:
  • Phone: 706-738-7246
  • Fax: 706-922-9267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number48228
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number48828
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number48828
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: