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General NPI Number Information
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NPI Number | 1114106564
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Entity Type | Organization
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Legal Business Name | JEFFREY K RICHARDS MD
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Dates
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Enumeration Date | 11/01/2007
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 1548 ASHLEY RIVER RD
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City | CHARLESTON
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State | SC
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Zip | 29407-5296
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Country | US
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Telephone | 843-769-5777
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Fax | 843-875-2873
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Provider Business Mailing Address
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Address Line | 1548 ASHLEY RIVER RD
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City | CHARLESTON
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State | SC
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Zip | 29407-5296
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Country | US
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Telephone | 843-769-5777
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Fax | 843-875-2873
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. JEFFREY K RICHARDS
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Credential | M.D.
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Telephone | 843-769-5777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 8566
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License Number State | SC
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