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General NPI Number Information
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NPI Number | 1891488235
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Entity Type | Organization
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Legal Business Name | DON L RICHARDSON, OD PSC
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Dates
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Enumeration Date | 05/31/2023
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Last Update Date | 05/31/2023
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Provider Practice Location Address
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Address Line | 246 POPLAR AVE STE 1
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City | SOMERSET
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State | KY
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Zip | 42503-1701
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Country | US
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Telephone | 606-679-5588
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Fax |
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Provider Business Mailing Address
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Address Line | 246 POPLAR AVE STE 1
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City | SOMERSET
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State | KY
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Zip | 42503-1701
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Country | US
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Telephone | 606-679-5588
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST, OWNER
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Name | DON L RICHARDSON
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Credential | OD
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Telephone | 606-679-5588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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