Individual
DR. MARK E RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4000 KRESGE WAY, PATHOLOGY DEPT, LOUISVILLE, KY 40207-4605
(502) 897-8226
(502) 897-8215
Mailing address
1169 EASTERN PKWY, SUITE G 71, LOUISVILLE, KY 40217-1417
(502) 456-6217
(502) 456-4440
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
21630
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000062182
ANTHEM BL CROSS BL SHIELD
KY
01
—
100373830A
MEDICAID INDIANA
IN
01
—
104509
HEALTH PARTNERS
KY
01
—
1049932
MEDICAID PASSPORT
KY
01
—
1100181
UNITED HEALTHCARE
KY
01
—
124519600
WORKERS COMP FLORIDA
FL
01
—
220020761
RAILROAD MEDICARE
—
01
—
2432721000
PASSPORT ADVANTAGE
KY
01
—
31155000400
WORKERS COMP OHIO
OH
05
—
64216302
—
KY
01
—
6598690
CIGNA HEALTHCARE
KY
Enumeration date
06/30/2006
Last updated
09/12/2011
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