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General NPI Number Information
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NPI Number | 1285749747
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Entity Type | Individual
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Provider Name | E RICHARD GROVES DPM
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 800 GORDON AVE
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City | THOMASVILLE
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State | GA
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Zip | 31792-6611
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Country | US
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Telephone | 229-226-1338
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Fax | 229-226-4888
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Provider Business Mailing Address
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Address Line | 800 GORDON AVE
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City | THOMASVILLE
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State | GA
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Zip | 31792-6611
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Country | US
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Telephone | 229-226-1338
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Fax | 229-226-4888
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | POD000551
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO1679
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License Number State | FL
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