Staie, Richard John

Staie, Richard John is an individual health care provider with primary practice located at 8954 Hospital Dr , Douglasville GA 30134-2272. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant. Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant is his primary health care specialty. Staie, Richard John can be contacted via phone (770) 920-6413.

Contact Information

Primary practice address
8954 Hospital Dr Douglasville GA 30134-2272
Phone: (770) 920-6413
Fax: (678) 838-2532
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 003918 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X 003918 Georgia

Profile Details

NPI number 1659353357
LBN Legal business name Staie, Richard John
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2005
Last updated May 29th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659353357 NPPES
Georgia MEDICAID 100002432B
Georgia MEDICAID 491431789A

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