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General NPI Number Information
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NPI Number | 1386938827
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Entity Type | Organization
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Legal Business Name | RICHARDSON MEDICAL SERVICES, PLLC
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Dates
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Enumeration Date | 06/01/2011
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Last Update Date | 06/01/2011
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Provider Practice Location Address
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Address Line | 5185 US ROUTE 60 E STE 30
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City | HUNTINGTON
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State | WV
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Zip | 25705-2003
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Country | US
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Telephone | 304-955-6350
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Fax |
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Provider Business Mailing Address
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Address Line | 5185 US ROUTE 60 E STE 30
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City | HUNTINGTON
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State | WV
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Zip | 25705-2003
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Country | US
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Telephone | 304-955-6350
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | BRADLEY J RICHARDSON
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Credential | M.D.
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Telephone | 304-634-6801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | WV18236
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License Number State | WV
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