Provider Demographics
NPI:1881666592
Name:RILEY, RENEE' S (MD)
Entity Type:Individual
Prefix:DR
First Name:RENEE'
Middle Name:S
Last Name:RILEY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:4181 HOSPITAL DR NE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-2541
Mailing Address - Country:US
Mailing Address - Phone:770-788-6534
Mailing Address - Fax:770-788-7658
Practice Address - Street 1:4181 HOSPITAL DR NE
Practice Address - Street 2:SUITE 204
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2541
Practice Address - Country:US
Practice Address - Phone:770-788-6534
Practice Address - Fax:770-788-7658
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2016-07-22
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Provider Licenses
StateLicense IDTaxonomies
GA067974207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003125883AMedicaid