Richardson, Willie D

Richardson, Willie D is an sole proprietor health care provider with primary practice located at 8316 Macon Ter Ste 102 , Cordova TN 38018-8505. He recently has only one registered license in Agencies / Home Health, which is considered as his primary health care specialty. Richardson, Willie D can be contacted via phone (901) 624-0371.

Contact Information

Primary practice address
8316 Macon Ter Ste 102 Cordova TN 38018-8505
Fax: (901) 624-0375
Website:

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X L000000022609 Tennessee

Profile Details

NPI number 1609347137
LBN Legal business name Richardson, Willie D
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 10th, 2018
Last updated Dec 10th, 2018 - about 8 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 1609347137 NPPES
Tennessee MEDICAID Q018034

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