Individual
DR. TIMOTHY GERARD RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11348 TARA BLVD STE 100, HAMPTON, GA 30228-6277
(404) 606-0712
Mailing address
11348 TARA BLVD STE 100, HAMPTON, GA 30228-6277
(404) 606-0712
Taxonomy
Speciality
Code
Description
License number
State
111NI0013X
Independent Medical Examiner Chiropractor
008459
GA
111NN0400X
Neurology Chiropractor
008459
GA
111NS0005X
Sports Physician Chiropractor
008459
GA
111NX0800X
Orthopedic Chiropractor
Primary
008459
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008459
—
GA
Enumeration date
06/23/2009
Last updated
07/20/2009
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