Individual
DR. PHILLIP E RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
7701 W ASPERA BLVD, GLENDALE, AZ 85308-7947
(623) 248-2100
Mailing address
7701 W ASPERA BLVD, GLENDALE, AZ 85308-7947
(623) 248-2100
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
041394
AZ
213ES0103X
Foot & Ankle Surgery Podiatrist
041394
KY
213ES0103X
Foot & Ankle Surgery Podiatrist
07001258A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041394
—
AZ
05
—
300004767
—
IN
Enumeration date
06/14/2011
Last updated
04/29/2024
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