# RICHMOND FOOT & ANKLE CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861669970
- **Authorized official:** DR. TANISHA R. RICHMOND (OWNER)
- **Authorized official phone:** (937) 228-3668

## Contact information

- **Practice address:** 1323 W 3RD ST, DAYTON, OH 45402-6714
- **Practice address phone:** (937) 228-3668
- **Practice address fax:** (937) 228-3660
- **Mailing address:** 1323 W 3RD ST, DAYTON, OH 45402-6714
- **Mailing address phone:** (937) 228-3668
- **Mailing address fax:** (937) 228-3660

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 36003457 | OH | Yes |

## Other

- **Enumeration date:** 05/08/2008
- **Last updated:** 05/03/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000571694 | ANTHEM | OH |
| 05 | — | 2796292 | — | OH |
| 05 | — | 2841492 | — | OH |
| 01 | — | 452898963002 | MMOH | OH |