Provider Demographics
NPI:1184637712
Name:SCHLEISSINGER, RICHARD J (DPM)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:SCHLEISSINGER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3459 ACWORTH DUE WEST RD NW
Mailing Address - Street 2:STE 430
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-5819
Mailing Address - Country:US
Mailing Address - Phone:770-529-9002
Mailing Address - Fax:770-529-9004
Practice Address - Street 1:3459 ACWORTH DUE WEST RD NW
Practice Address - Street 2:STE 430
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-5819
Practice Address - Country:US
Practice Address - Phone:770-529-9002
Practice Address - Fax:770-529-9004
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA000867213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA48SCCDGMedicare ID - Type Unspecified
GAU73817Medicare UPIN