Organization
RICHMOND FOOT & ANKLE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TANISHA R. RICHMOND (OWNER)
(937) 228-3668
Entity
Organization
Contact information
Practice address
1323 W 3RD ST, DAYTON, OH 45402-6714
(937) 228-3668
(937) 228-3660
Mailing address
1323 W 3RD ST, DAYTON, OH 45402-6714
(937) 228-3668
(937) 228-3660
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36003457
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000571694
ANTHEM
OH
05
—
2796292
—
OH
05
—
2841492
—
OH
01
—
452898963002
MMOH
OH
Enumeration date
05/08/2008
Last updated
05/03/2010
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