Individual
HARRY LEE RICHARDSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
514 10TH AVE SW, REFORM, AL 35481
(205) 375-6251
(205) 375-8199
Mailing address
PO BOX 670, REFORM, AL 35481-0670
(205) 375-6251
(205) 375-8199
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
10330
MS
207Q00000X
Family Medicine Physician
Primary
11725
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120095
—
MS
01
—
009972520
ALABAMA MEDICAID
MS
01
—
562251777
BLUE CROSS
MS
01
—
7306387RIC
ALABAMA BLUE CROSS
MS
01
—
P00204381
RAILROAD MEDICARE
MS
Enumeration date
06/13/2006
Last updated
06/26/2018
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