Individual
KELLY R. RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2501 CITICO AVE, CHATTANOOGA, TN 37404-1127
(423) 697-2000
(423) 697-2118
Mailing address
1800 HARRISON ST FL 7, OAKLAND, CA 94612-3429
(510) 625-6262
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
57951
TN
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
57951
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57951
MEDICAL LICENSE
TN
Enumeration date
10/27/2006
Last updated
09/21/2018
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