Richardson, Stephen M

Richardson, Stephen M is an sole proprietor health care provider with primary practice located at 430 Neal St , Cookeville TN 38501-0916. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Richardson, Stephen M can be contacted via phone (931) 528-6411.

Contact Information

Primary practice address
430 Neal St Cookeville TN 38501-0916
Fax: (931) 372-0380
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ODT-1155 Tennessee

Profile Details

NPI number 1801895438
LBN Legal business name Richardson, Stephen M
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 15th, 2005
Last updated Apr 5th, 2023 - about last year

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 1801895438 NPPES
Other 0095470 BCBS TN
MEDICAID 3596618 BCBS TN

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