Healthcare Provider Details

I. General information

NPI: 1215000468
Provider Name (Legal Business Name): WILLIAM B RICHARDSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 TOBIAS GADSON BLVD STE 130
CHARLESTON SC
29407-4970
US

IV. Provider business mailing address

PO BOX 96191
CHARLOTTE NC
28296-6191
US

V. Phone/Fax

Practice location:
  • Phone: 770-962-3642
  • Fax: 770-962-3643
Mailing address:
  • Phone: 770-962-3642
  • Fax: 770-962-3643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number40919
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number25014
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number25014
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number229853
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: