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NPI Code Detail

MEDICARE: DR. JEFF S RICHARDSON DPM

MEDICARE:  DR. JEFF S RICHARDSON  DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213ES0103XFoot & Ankle Surgery Podiatrist00362KY
2213ES0131XFoot Surgery PodiatristPO3837FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1K002223OTHERKYMEDICARE PTAN

General Provider Information

NPI Number : 1710204862
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFF S RICHARDSON DPM
Provider Business Mailing Address
First Line : 1401 HARRODSBURG RD
Second Line : SUITE C-115
City : LEXINGTON
State : KY
Zip : 40504-1764
Country : US
Telephone Number : 859-278-8855
Fax Number : 859-278-8856
Provider Business Practice Location Address
First Line : 1401 HARRODSBURG RD
Second Line : SUITE C-115
City : LEXINGTON
State : KY
Zip : 40504-1764
Country : US
Telephone Number : 859-278-8855
Fax Number : 859-278-8856
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2010
Last Update Date : 04/26/2017

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Directions to “ DR. JEFF S RICHARDSON DPM” Practice Location

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