Richardson, Candie M

Richardson, Candie M is an individual health care provider with primary practice located at 2525 Desales Avenue , Chattanooga TN 37404. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Richardson, Candie M can be contacted via phone (423) 697-0014.

Contact Information

Primary practice address
2525 Desales Avenue Chattanooga TN 37404
Phone: (423) 697-0014
Fax: (423) 648-6280
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 35084133 Ohio
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X N1427 Texas
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD45988 Tennessee

Profile Details

NPI number 1467442111
LBN Legal business name Richardson, Candie M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Nov 18th, 2011 - about 14 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 1467442111 NPPES
Tennessee MEDICAID 1521416

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