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HARRY LEE RICHARDSON MD

>> Emergency Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1780627356

Individual Registrant:
 HARRY LEE RICHARDSON MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
514 10TH AVE SW  REFORM, AL 35481 US
Tel: 205-375-6251  Fax: 205-375-8199

Contact information for business:
PO BOX 670  REFORM, AL 35481-0670 US
Tel: 205-375-6251  Fax: 205-375-8199

Registration Information:
NPI: 1780627356
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207P00000XAllopathic & Osteopathic Physicians
Emergency Medicine
MS10330
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
AL11725

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BLUE CROSS562251777MS01
00120095MS05
ALABAMA MEDICAID009972520MS01
ALABAMA BLUE CROSS7306387RICMS01
RAILROAD MEDICAREP00204381MS01




HEALTH CARE JOBS AL - Page 1



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