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Organization
DR. EUGENE A. RICHARDSON III
Active
Organization
DR. EUGENE A. RICHARDSON III
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGENE ARTHUR RICHARDSON III (DENTIST)
(804) 861-5330
Entity
Organization
Contact information
Practice address
23 SHORE ST, PETERSBURG, VA 23803-5818
(804) 861-5331
(804) 861-5351
Mailing address
23 SHORE ST, PETERSBURG, VA 23803-5818
(804) 861-5331
(804) 861-5351
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401005258
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003363
ANTHEM
VA
01
—
4066921
BC/BS
TN
01
—
691160
UNITED CONCORDIA
PA
05
—
9178831
—
VA
Enumeration date
03/03/2008
Last updated
03/03/2008
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