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Individual

DR. CHARLIE E RICHARDSON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
309 NE MARION ST, MADISON, FL 32340-2511
(850) 973-3456
(850) 973-9399
Mailing address
2740 HICKORY RIDGE RD, TALLAHASSEE, FL 32308-4010
(850) 552-0922
(850) 553-6192

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME30397
FL

Other

Enumeration date
10/13/2005
Last updated
07/08/2007
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