Individual
TOMMIE MACK RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 TECHNOLOGY CT SE STE J, SMYRNA, GA 30082-5237
(770) 866-5700
(770) 436-7143
Mailing address
4015 S COBB DR, #115, SMYRNA, GA 30080
(770) 431-2354
(770) 436-7143
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
031313
GA
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
31313
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000471479F
—
GA
Enumeration date
10/12/2006
Last updated
12/07/2023
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