Individual
DR. CHARLES DAVID RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 HOSPITAL DR W, HATTIESBURG, MS 39402-1334
(601) 268-5910
(601) 264-0659
Mailing address
100 HOSPITAL DR W, HATTIESBURG, MS 39402-1334
(601) 268-5910
(601) 264-0659
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
10012
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00016828
—
MS
01
—
10012
MEDICAL LICENSE
MS
Enumeration date
08/25/2006
Last updated
03/07/2023
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