Larry B. Mellick
MD | Pediatric Emergency Medicine | Male
Larry B. Mellick, MD is a Augusta, Georgia based Pediatric doctor with medical specialization in
Pediatric Emergency Medicine.
Current practice location of Larry B. Mellick is
1120 15th St, Augusta, Georgia - 30912-0004. He can be contacted on phone at
706-721-4951 and fax number 706-721-7941.
Larry B. Mellick is a sole proprietor of his business.
NPI number (Unique professional ID) for Larry B. Mellick is
1841309804 which was assigned by NPPES on 30 Aug, 2006 and it was last updated on 31 Mar, 2011.
Larry B. Mellick license number is
042892 for Pediatrics Pediatric Emergency Medicine (2080P0204X) in Georgia.
Larry B. Mellick has special qualifications to manage emergencies in infants and children.
Complete Profile:
Larry B. Mellick basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Pediatric Emergency Medicine |
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| Provider Name : | Larry B. Mellick |
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| Credential : | MD |
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| Gender : | Male |
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Business Address:
Larry B. Mellick address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 1120 15th St
Augusta, GA, 30912-0004
United States |
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| Phone Number : | 706-721-4951 |
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| Fax Number : | 706-721-7941 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1841309804 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 30 Aug, 2006 |
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| Last Updated On : | 31 Mar, 2011 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Larry B. Mellick are as mentioned. Primary taxonomy code for Larry B. Mellick, MD is
2080P0204X (Pediatrics Pediatric Emergency Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 2080P0204X | Pediatrics Pediatric Emergency Medicine | Yes | 042892 | GA |
Legacy Identifiers:
Other legacy medical identifiers of Larry B. Mellick such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 000729319A | MEDICAID | GA | |
| G60514 | MEDICAID | SC | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 1499 Walton Way, Ste 1400
Augusta, GA, 30901-2602
United States |
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| Phone Number : | 706-828-6410 |
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Business Location:
Patients can refer following map for directions to
Larry B. Mellick practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.