Mr Gregory V Richardson, MD | |
505 N. Wabash Ave, Marion, IN 46952 | |
(765) 662-3971 | |
(765) 668-6718 |
Full Name | Mr Gregory V Richardson |
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Gender | Male |
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 505 N. Wabash Ave, Marion, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215095773 | NPI | - | NPPES |
100323530 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | 01032282 (Indiana) | Secondary |
2084P0800X | Psychiatry & Neurology - Psychiatry | 01032282A (Indiana) | Primary |
Entity Name | Centerstone Of Indiana, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1992781470 PECOS PAC ID: 9436138427 Enrollment ID: O20040830000711 |
Mailing Address | Practice Location Address |
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Mr Gregory V Richardson, MD 505 N. Wabash Ave, Marion, IN 46952 Ph: (765) 662-3971 | Mr Gregory V Richardson, MD 505 N. Wabash Ave, Marion, IN 46952 Ph: (765) 662-3971 |
Dr. Michel Calache, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1028 N Wabash Ave, Marion, IN 46952 Phone: 765-664-1578 | |
Escolastico Ausejo Deloria Jr., M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1700 E 38th St, Marion, IN 46953 Phone: 765-674-6965 | |
Patricia L Harralson, Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 505 N Wabash Ave, Marion, IN 46952 Phone: 765-662-3971 | |
Dr. Avelina Te Vitug, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1700 E 38th St, Marion, IN 46953 Phone: 765-674-3321 | |
Elizabeth Anne Martin, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1700 E 38th St, Marion, IN 46953 Phone: 765-674-3321 Fax: 765-677-5115 | |
Dr. Michael Harold Conn, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 505 Wabash Ave, Marion, IN 46952 Phone: 619-403-2215 |