Healthcare Provider Details

I. General information

NPI: 1215891601
Provider Name (Legal Business Name): RICHARD MILLIRON PARAMEDIC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 LINCOLN ST
HOGANSVILLE GA
30230-1335
US

IV. Provider business mailing address

130 CULPEPPER RD
ECLECTIC AL
36024-6061
US

V. Phone/Fax

Practice location:
  • Phone: 706-637-6648
  • Fax:
Mailing address:
  • Phone: 706-637-6648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number8370
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: