Individual
JOHN DAVID RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
439 N JACKSON ST STE D, BROOKHAVEN, MS 39601-2912
(601) 835-9499
(601) 833-7808
Mailing address
439 N JACKSON ST STE D, BROOKHAVEN, MS 39601-2912
(601) 835-9499
(601) 833-7808
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
11411
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119784
—
MS
Enumeration date
08/09/2006
Last updated
01/11/2019
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