Richardson, Norman Gregory

Richardson, Norman Gregory is an sole proprietor health care provider with primary practice located at 475 Yellowstone Ave Suite G, Pocatello ID 83201-4528. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Richardson, Norman Gregory can be contacted via phone (208) 233-1551.

Contact Information

Primary practice address
475 Yellowstone Ave Suite G Pocatello ID 83201-4528
Fax: (208) 232-7896
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ODP680 Idaho

Profile Details

NPI number 1346251063
LBN Legal business name Richardson, Norman Gregory
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 10th, 2006
Last updated Jul 6th, 2024 - about last year

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 1346251063 NPPES
Idaho MEDICAID 002555400

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