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General NPI Number Information
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NPI Number | 1003885088
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Entity Type | Individual
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Provider Name | RICHARD W. TOWNSEND MD
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Gender | Male
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 01/13/2022
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Provider Practice Location Address
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Address Line | 351 TOWN PLAZA AVE STE 105A
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City | PONTE VEDRA
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State | FL
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Zip | 32081-5178
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Country | US
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Telephone | 904-819-3233
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Fax | 904-456-0819
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Provider Business Mailing Address
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Address Line | PO BOX 3266
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32085-3266
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME74955
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License Number State | FL
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