Provider Demographics
NPI:1861408254
Name:MAGUIRE, RICHARD R (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:R
Last Name:MAGUIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 INTERSTATE NORTH CIR SE STE 500
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2296
Mailing Address - Country:US
Mailing Address - Phone:770-953-6929
Mailing Address - Fax:
Practice Address - Street 1:970 JOE FRANK HARRIS PKWY SE STE 100
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-2160
Practice Address - Country:US
Practice Address - Phone:770-445-5666
Practice Address - Fax:770-445-0799
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058278207XX0005X, 207X00000X
CAA78560207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA058278OtherSTATE LICENSE
H69573Medicare UPIN
20NCCPFMedicare PIN