Provider Demographics
NPI:1245360247
Name:SCHICK, RICHARD THOMAS (PA-C)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:THOMAS
Last Name:SCHICK
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 CONCORD RD SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-4361
Mailing Address - Country:US
Mailing Address - Phone:770-333-8889
Mailing Address - Fax:770-333-8948
Practice Address - Street 1:1314 CONCORD RD SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4361
Practice Address - Country:US
Practice Address - Phone:770-333-8889
Practice Address - Fax:770-333-8948
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002164363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA252129898AMedicaid