MEDICARE: BROOKS RICHARDSON MD

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	207RG0100X	Gastroenterology Physician	56518	KY

General Provider Information

NPI Number	:	1518490341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKS RICHARDSON MD

Provider Business Mailing Address
First Line	:	1780 NICHOLASVILLE RD STE 202
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-1412
Country	:	US
Telephone Number	:	859-260-5051
Fax Number	:	859-260-5052

Provider Business Practice Location Address
First Line	:	1780 NICHOLASVILLE RD STE 202
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-1412
Country	:	US
Telephone Number	:	859-260-5051
Fax Number	:	859-260-5052

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

Provider Enumeration Date	:	04/08/2017
Last Update Date	:	06/02/2025

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Directions to “ BROOKS RICHARDSON MD” Practice Location

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