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General NPI Number Information
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NPI Number | 1396788873
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Entity Type | Individual
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Provider Name | ERIC J RICHARDSON DPM
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Gender | Male
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 2037 JERRY MURPHY RD STE 100
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City | PUEBLO
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State | CO
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Zip | 81001-1256
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Country | US
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Telephone | 719-544-5958
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Fax | 719-544-5991
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Provider Business Mailing Address
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Address Line | 2037 JERRY MURPHY RD STE 100
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City | PUEBLO
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State | CO
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Zip | 81001-1256
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Country | US
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Telephone | 719-544-5958
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Fax | 719-544-5991
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 595
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 595
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License Number State | CO
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