Gendron, Richard

Gendron, Richard is an individual health care provider with primary practice located at 2033 Meadowview Ln Ste 200, Kingsport TN 37660-7569. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Gendron, Richard can be contacted via phone (423) 857-2260.

Contact Information

Primary practice address
2033 Meadowview Ln Ste 200 Kingsport TN 37660-7569
Fax: (423) 857-2261
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101025181 Virginia
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD 11397 Tennessee

Profile Details

NPI number 1720081557
LBN Legal business name Gendron, Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2005
Last updated Sep 16th, 2009 - about 15 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 1720081557 NPPES
Virginia MEDICAID 006713602
Virginia MEDICAID 6713602
Virginia MEDICAID 3898501
Virginia MEDICAID 5440943

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