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Individual

JOHN TYLER RICHARDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
625 19TH ST S, BIRMINGHAM, AL 35233-1900
(205) 934-7700
Mailing address
PO BOX 55310, ATTN: MSO CREDENTIALING, BIRMINGHAM, AL 35255
(205) 731-9701
(205) 297-9411

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
33866
AL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/29/2013
Last updated
07/21/2017
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