Healthcare Provider Details

I. General information

NPI: 1154305977
Provider Name (Legal Business Name): ALVIE C. RICHARDSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1981 E BONANZA CT STE 201
GILBERT AZ
85297-8013
US

IV. Provider business mailing address

1981 E BONANZA CT STE 201
GILBERT AZ
85297-8013
US

V. Phone/Fax

Practice location:
  • Phone: 480-756-6000
  • Fax: 855-636-8770
Mailing address:
  • Phone: 480-756-6000
  • Fax: 855-636-8770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number49823
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number49823
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number77571
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberC160063
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC160063
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: