Lake Oconee Urgent and Specialty Care Center

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

7235 Issued in GA

Legal business name

LAKE OCONEE URGENT AND SPECIALTY CARE CENTER

Practice address

105 Harmony Xing
Suite 3
Eatonton, GA 31024-9522

Phone

(706) 484-0884

NPI assigned

Jul 31, 2014

Last updated

Jul 31, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Eddie Richardson, M.D.NPI 1235107772

Title

Physician/Practice Owner

Phone

(706) 484-0884

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eddie Richardson, MD

  • Family Medicine Physician
  • Eatonton, GA
  • NPI 1235107772
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406764800000",
    "number": "1235547431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 LANCASTER DR SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136440",
            "telephone_number": "404-405-7596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 HARMONY XING",
            "address_2": "SUITE 3",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310249522",
            "telephone_number": "706-484-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE OCONEE URGENT AND SPECIALTY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_title_or_position": "PHYSICIAN/PRACTICE OWNER",
        "authorized_official_telephone_number": "706-484-0884",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "7235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Country Physical Therapy LLC
• Lake Oconee Medical Associates LLC
• Lake Oconee Partners in Healthcare, LLC
• Lake Oconee Pharmacy & Compounding Center
• Lake Oconee Rehabilitation and Performance Center, LLC
• Lakeside Oral Surgery, LLC
• Haley Brogden Lance, D.C.
• Justin Andrew Lance, D.C.
• Larson Chiropractic Wellness Center
• Michelle Lee

• Medical Physician Assistant in Eatonton, GA
• Providers in Eatonton, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.