Richardson, Carol

Richardson, Carol is an individual health care provider with primary practice located at 103 S 12Th Ave , Laurel MS 39440-4322. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is her primary health care specialty. Richardson, Carol can be contacted via phone (601) 399-1970.

Contact Information

Primary practice address
103 S 12Th Ave Laurel MS 39440-4322
Phone: (601) 399-1970
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301073267 Michigan
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 25238 Mississippi

Profile Details

NPI number 1073051892
LBN Legal business name Richardson, Carol
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2017
Last updated Nov 2nd, 2017 - about 9 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 1073051892 NPPES
Mississippi MEDICAID 03937772

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