| Dr. Eugene A. Richardson Iii | |
|
23 Shore St Petersburg VA 23803-5818 | |
| (804) 861-5331 | |
| (804) 861-5351 |
| Full Name | Dr. Eugene A. Richardson Iii |
|---|---|
| Speciality | Dentist |
| Location | 23 Shore St, Petersburg, Virginia |
| Authorized Official Name and Position | Eugene Arthur Richardson (DENTIST) |
| Authorized Official Contact | 8048615330 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Eugene A. Richardson Iii 23 Shore St Petersburg VA 23803-5818 Ph: (804) 861-5331 | Dr. Eugene A. Richardson Iii 23 Shore St Petersburg VA 23803-5818 Ph: (804) 861-5331 |
| NPI Number | 1184894404 |
|---|---|
| Provider Enumeration Date | 03/03/2008 |
| Last Update Date | 03/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184894404 | NPI | - | NPPES |
| 9178831 | Medicaid | VA | |
| 003363 | Other | VA | ANTHEM |
| 691160 | Other | PA | UNITED CONCORDIA |
| 4066921 | Other | TN | BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 0401005258 (Virginia) | Primary |
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