Provider Demographics
NPI:1821095670
Name:RICHARDSON-ONEAL, LORRIE ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:LORRIE
Middle Name:ANN
Last Name:RICHARDSON-ONEAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 TOWNE CENTER PKWY 114
Mailing Address - Street 2:
Mailing Address - City:HOSCHTON
Mailing Address - State:GA
Mailing Address - Zip Code:30548-2222
Mailing Address - Country:US
Mailing Address - Phone:706-685-0588
Mailing Address - Fax:706-684-0753
Practice Address - Street 1:115 TOWNE CENTER PKWY 114
Practice Address - Street 2:
Practice Address - City:HOSCHTON
Practice Address - State:GA
Practice Address - Zip Code:30548-2222
Practice Address - Country:US
Practice Address - Phone:706-684-0588
Practice Address - Fax:706-684-0753
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA60976207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA460213700AMedicaid
GA511G701203Medicare PIN
GAG55348Medicare UPIN