Provider Demographics
NPI:1629047766
Name:EPTER, RICHARD STUART (MD,DABPM,FIPP)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:STUART
Last Name:EPTER
Suffix:
Gender:M
Credentials:MD,DABPM,FIPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 INTERSTATE PKWY
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-5626
Mailing Address - Country:US
Mailing Address - Phone:706-738-7246
Mailing Address - Fax:706-922-9267
Practice Address - Street 1:1321 INTERSTATE PKWY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-5626
Practice Address - Country:US
Practice Address - Phone:706-738-7246
Practice Address - Fax:706-922-9267
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA48228174400000X
GA48828208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No174400000XOther Service ProvidersSpecialist
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA050088973OtherMEDICARE RR
SCG-48228Medicaid
GA00797233CMedicaid
GA050088973OtherMEDICARE RR
SCG-48228Medicaid