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
Phone: (208) 233-1551
Fax: (208) 232-7896
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346251063 | NPPES |
| Idaho | MEDICAID | 002555400 |
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