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NPI Code Detail

MEDICARE: JONATHAN A RICHARD MD

MEDICARE: JONATHAN A RICHARD 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1679421911
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN A RICHARD MD
Provider Business Mailing Address
First Line : 3651 WHEELER RD # 1
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-6426
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3651 WHEELER RD
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-6426
Country : US
Telephone Number : 705-651-3232
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2026
Last Update Date : 03/20/2026

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