MEDICARE: ALEXANDER RICHARDSON DPM

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	213E00000X	Podiatrist	36003163	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	480029911	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356344923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER RICHARDSON DPM

Provider Business Mailing Address
First Line	:	3116 W US HIGHWAY 22 AND 3
Second Line	:	STE E
City	:	MAINEVILLE
State	:	OH
Zip	:	45039-8609
Country	:	US
Telephone Number	:	513-683-2060
Fax Number	:

Provider Business Practice Location Address
First Line	:	3116 W US HIGHWAY 22 AND 3
Second Line	:	STE E
City	:	MAINEVILLE
State	:	OH
Zip	:	45039-8609
Country	:	US
Telephone Number	:	513-683-2060
Fax Number	:

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	11/22/2016

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Directions to “ ALEXANDER RICHARDSON DPM” Practice Location

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