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General NPI Number Information
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NPI Number | 1164472478
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Entity Type | Organization
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Legal Business Name | AR MEDICAL LLC
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 01/23/2008
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Provider Practice Location Address
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Address Line | 502 E GENERAL STEWART WAY
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City | HINESVILLE
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State | GA
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Zip | 31313-2629
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Country | US
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Telephone | 912-368-4169
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Fax | 912-368-5667
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Provider Business Mailing Address
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Address Line | 809 PEACHTREE ST
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City | LOUISVILLE
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State | GA
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Zip | 30434-1449
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Country | US
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Telephone | 478-625-7597
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Fax | 478-625-8364
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FIROZ PATKA
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Credential | M.D.
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Telephone | 478-625-7597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 052399
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 055918
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License Number State | GA
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