Provider Demographics
NPI:1871857482
Name:GLOVER, RICHARD L JR (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:GLOVER
Suffix:JR
Gender:M
Credentials:DO
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Mailing Address - Street 1:5780 PEACHTREE DUNWOODY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1513
Mailing Address - Country:US
Mailing Address - Phone:404-303-8035
Mailing Address - Fax:404-303-1325
Practice Address - Street 1:3905 BROOKSIDE PKWY STE 201
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-4429
Practice Address - Country:US
Practice Address - Phone:770-521-2295
Practice Address - Fax:770-255-0333
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2022-02-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA82529207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP3569OtherMEDICARE
GA003218899IMedicaid