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Individual

KEIFER DEWAYNE RICHARDSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2050 WALTON WAY, AUGUSTA, GA 30904-2305
(706) 434-1590
Mailing address
526 RICHLAND AVE W, AIKEN, SC 29801-3828
(803) 648-3130
(803) 648-9860

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
PA2880
SC
363AM0700X
Medical Physician Assistant
Primary
9335
GA

Other

Enumeration date
01/18/2018
Last updated
01/16/2025
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