Individual
NATHAN DAVIS RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3420 S MERCY RD, SUITE 200, GILBERT, AZ 85297-0419
(623) 537-5600
(866) 939-2673
Mailing address
3010 W AGUA FRIA FWY, SUITE 100, PHOENIX, AZ 85027-3943
(623) 537-5600
(866) 939-2673
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
42715
AZ
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
42715
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
521790
—
AZ
01
—
5550830001
MEDICARE NSC SCW
AZ
01
—
5550830003
MEDICARE NSC PEORIA
AZ
01
—
5550830007
MEDICARE NSC DV
AZ
01
—
5550830010
MEDICARE NSC GILBERT
AZ
01
—
5550830011
MEDICARE NSC CENTRAL PHOENIX
AZ
01
—
5550830012
MEDICARE NSC SPINE CENTER
AZ
Enumeration date
12/14/2006
Last updated
05/18/2012
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