Provider Demographics
NPI:1245076306
Name:HERRINGTON, RICHARD
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:HERRINGTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 TOWN CREEK CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:TALKING ROCK
Mailing Address - State:GA
Mailing Address - Zip Code:30175-2527
Mailing Address - Country:US
Mailing Address - Phone:678-333-5669
Mailing Address - Fax:
Practice Address - Street 1:55 WHITCHER ST NE STE 250
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1169
Practice Address - Country:US
Practice Address - Phone:770-428-4475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant