Provider Information for 1376318808
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RICHARD KYLE MCCRANIE
Sex: Male
NPI: 1376318808
Last Updated: 2023-11-15
Certification Date: 2023-11-15
Certification Date: 2023-11-15
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1376318808 | ||||||||
| Enumeration Date | 2023-11-15 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1231 CEDAR PARK CIR STONE MOUNTAIN, GA 30083-1863 United States Phone: 404-594-3556 | Fax: | ||||||||
| Primary Practice Address | 1231 CEDAR PARK CIR STONE MOUNTAIN, GA 30083-1863 United States Phone: 404-594-3556 | Fax: | ||||||||
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