Richardson, John Edward

Richardson, John Edward is an individual health care provider with primary practice located at 300 Busch Dr , Jacksonville FL 32218-5551. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Richardson, John Edward can be contacted via phone (904) 757-3886.

Contact Information

Primary practice address
300 Busch Dr Jacksonville FL 32218-5551
Phone: (904) 757-3886
Fax: (904) 757-9771
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPC2384 Florida

Profile Details

NPI number 1174795801
LBN Legal business name Richardson, John Edward
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 2nd, 2008
Last updated Feb 16th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174795801 NPPES
Florida MEDICAID 078775200

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