Healthcare Provider Details

I. General information

NPI: 1487917068
Provider Name (Legal Business Name): DAMIEN RICHARDSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2012
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 N DOBSON RD STE 201
SCOTTSDALE AZ
85256
US

IV. Provider business mailing address

PO BOX 5105
BELFAST ME
04915-5100
US

V. Phone/Fax

Practice location:
  • Phone: 480-733-7400
  • Fax: 480-207-2117
Mailing address:
  • Phone: 828-258-8800
  • Fax: 828-651-0026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2025-01292
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number71257
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: