Provider Demographics
NPI:1457589186
Name:SPRINGER, RACHAEL TRICIA (MD)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:TRICIA
Last Name:SPRINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 SIGMAN RD NE STE 190
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-3924
Mailing Address - Country:US
Mailing Address - Phone:770-922-4024
Mailing Address - Fax:
Practice Address - Street 1:55 LAKE AVE N
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01655-0002
Practice Address - Country:US
Practice Address - Phone:774-443-7057
Practice Address - Fax:508-856-4224
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301094790208600000X
GA075906208600000X
NC2016-015982086S0102X
FLME1230412086S0102X
IN01087996A2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care