Provider Demographics
NPI:1972131209
Name:RICCIARDELLI VOKRRI, JULIE (MD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:RICCIARDELLI VOKRRI
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 1:433 US HIGHWAY 80 W
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-2509
Mailing Address - Country:US
Mailing Address - Phone:912-755-9869
Mailing Address - Fax:912-550-4467
Practice Address - Street 1:433 US HIGHWAY 80 W
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-2509
Practice Address - Country:US
Practice Address - Phone:912-755-9869
Practice Address - Fax:912-550-4467
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-31
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA94835207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine