Provider Demographics
NPI:1407530744
Name:SANDERS, RICHARD PARKER
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:PARKER
Last Name:SANDERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1572 ANDERSON HWY
Mailing Address - Street 2:
Mailing Address - City:HARTWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30643-7197
Mailing Address - Country:US
Mailing Address - Phone:706-498-1660
Mailing Address - Fax:706-377-5031
Practice Address - Street 1:1572 ANDERSON HWY
Practice Address - Street 2:
Practice Address - City:HARTWELL
Practice Address - State:GA
Practice Address - Zip Code:30643-7197
Practice Address - Country:US
Practice Address - Phone:706-498-1660
Practice Address - Fax:706-377-5031
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALDO002392156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician