Individual
TY E RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4130 DUTCHMANS LN, STE 300, LOUISVILLE, KY 40207-4713
(502) 897-1794
(502) 897-0093
Mailing address
4130 DUTCHMANS LN, STE 300, LOUISVILLE, KY 40207-4713
(502) 897-1794
(502) 897-0093
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
31339
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000179986
ANTHEM INS
—
05
—
64015753
—
KY
01
—
7807142
AETNA INS
—
01
—
9481389002
CIGNA INS
—
Enumeration date
11/02/2005
Last updated
04/16/2015
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