MEDICARE: JAMES P RICHMOND JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	MDO14674	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	180006129	OTHER	TN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0028839	OTHER	TN	BCBSTN

General Provider Information

NPI Number	:	1184620288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES P RICHMOND JR. M.D.

Provider Business Mailing Address
First Line	:	932 SPRING CREEK RD
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37412-3910
Country	:	US
Telephone Number	:	423-894-1453
Fax Number	:	423-899-8022

Provider Business Practice Location Address
First Line	:	932 SPRING CREEK RD
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37412-3910
Country	:	US
Telephone Number	:	423-894-1453
Fax Number	:	423-899-8022

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	03/23/2009

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