Richardson, Tommie Mack

Richardson, Tommie Mack is an individual health care provider with primary practice located at 400 Technology Ct Se Ste J , Smyrna GA 30082-5237. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Richardson, Tommie Mack can be contacted via phone (770) 866-5700.

Contact Information

Primary practice address
400 Technology Ct Se Ste J Smyrna GA 30082-5237
Phone: (770) 866-5700
Fax: (770) 436-7143
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 031313 Georgia
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X 31313 Georgia

Profile Details

NPI number 1013006584
LBN Legal business name Richardson, Tommie Mack
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2006
Last updated Dec 7th, 2023 - about 2 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 1013006584 NPPES
Georgia MEDICAID 000471479F

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