Provider Demographics
NPI:1760456362
Name:SAMS, RICHARD WOODVILLE II (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WOODVILLE
Last Name:SAMS
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:881 USS JAMES MADISON RD
Mailing Address - Street 2:BRANCH HEALTH CLINIC KINGS BAY
Mailing Address - City:KINGS BAY
Mailing Address - State:GA
Mailing Address - Zip Code:31547
Mailing Address - Country:US
Mailing Address - Phone:912-573-8801
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HOSPITAL JACKSONVILLE
Practice Address - Street 2:2080 CHILD ST.
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32214-0001
Practice Address - Country:US
Practice Address - Phone:904-542-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI38109-020207Q00000X
GA077414207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine