Individual
DR. STEPHEN M RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
430 NEAL ST, COOKEVILLE, TN 38501-0916
(931) 528-6411
(931) 372-0380
Mailing address
430 NEAL ST, COOKEVILLE, TN 38501-0916
(931) 528-6411
(931) 372-0380
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT-1155
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0095470
BCBS TN
—
05
—
3596618
—
TN
Enumeration date
07/15/2005
Last updated
04/05/2023
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