Provider Demographics
NPI:1700887437
Name:BLAND, JAMES RICHARD II (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RICHARD
Last Name:BLAND
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:119 AMBULANCE DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-3857
Mailing Address - Country:US
Mailing Address - Phone:770-838-8787
Mailing Address - Fax:770-838-8922
Practice Address - Street 1:165 CLINIC AVE
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-4413
Practice Address - Country:US
Practice Address - Phone:770-836-9824
Practice Address - Fax:770-836-9850
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2017-04-11
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Provider Licenses
StateLicense IDTaxonomies
GA0287272085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000328402CMedicaid
GA000328402CMedicaid
GA30BDKYMedicare ID - Type Unspecified