Richardson, Timothy Gerard

Richardson, Timothy Gerard is an sole proprietor health care provider with primary practice located at 11348 Tara Blvd Ste 100 , Hampton GA 30228-6277. He recently has 4 registered licenses in different health care specialties including Chiropractic Providers / Independent Medical Examiner, Chiropractic Providers / Neurology, Chiropractic Providers / Sports Physician, Chiropractic Providers / Orthopedic. Chiropractic Providers / Orthopedic is his primary health care specialty. Richardson, Timothy Gerard can be contacted via phone (404) 606-0712.

Contact Information

Primary practice address
11348 Tara Blvd Ste 100 Hampton GA 30228-6277
Phone: (404) 606-0712
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Independent Medical Examiner 111NI0013X 008459 Georgia
Chiropractic Providers / Neurology 111NN0400X 008459 Georgia
Chiropractic Providers / Sports Physician 111NS0005X 008459 Georgia
Chiropractic Providers / Orthopedic 111NX0800X 008459 Georgia

Profile Details

NPI number 1326276858
LBN Legal business name Richardson, Timothy Gerard
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 23rd, 2009
Last updated Jul 20th, 2009 - about 17 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 1326276858 NPPES
Georgia MEDICAID 008459

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