Individual
MARY RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
800 ROSE ST, DIVISION OF CARDIOLOGY, LEXINGTON, KY 40536-0200
(859) 323-3976
(859) 257-6060
Mailing address
900 S LIMESTONE CTW 324, DIVISION OF CARDIOLOGY, LEXINGTON, KY 40536-0200
(859) 323-3976
(859) 257-6060
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA597
KY
363AM0700X
Medical Physician Assistant
PA597
KY
363AS0400X
Surgical Physician Assistant
PA597
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0987654310
—
KY
Enumeration date
07/31/2006
Last updated
08/28/2025
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