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General NPI Number Information
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NPI Number | 1154595577
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Entity Type | Organization
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Legal Business Name | RICHARDSON & BAKER PC
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 3400 HIGHWAY 78 E MEDICAL ARTS TOWER SUITE 502
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City | JASPER
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State | AL
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Zip | 35501-8907
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Country | US
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Telephone | 205-221-4916
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Fax | 205-221-4939
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Provider Business Mailing Address
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Address Line | 3400 HIGHWAY 78 E MEDICAL ARTS TOWER SUITE 502
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City | JASPER
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State | AL
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Zip | 35501-8907
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Country | US
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Telephone | 205-221-4916
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Fax | 205-221-4939
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Authorized Official
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Title or Position | OFFICE MGR
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Name | CHERYL WALDROP
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Credential |
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Telephone | 205-221-4916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State | AL
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