| Richardson Psychiatric P.a. | |
|
4500 I 55 N Ste 234 Jackson MS 39211-5932 | |
| (601) 982-8531 | |
| (601) 982-1115 |
| Full Name | Richardson Psychiatric P.a. |
|---|---|
| Speciality | Psychiatry & Neurology - Geriatric Psychiatry |
| Location | 4500 I 55 N Ste 234, Jackson, Mississippi |
| Authorized Official Name and Position | John D Richardson (OWNER/PRESIDENT) |
| Authorized Official Contact | 6019828535 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richardson Psychiatric P.a. 4500 I 55 N Ste 234 Jackson MS 39211-5932 Ph: (601) 982-8531 | Richardson Psychiatric P.a. 4500 I 55 N Ste 234 Jackson MS 39211-5932 Ph: (601) 982-8531 |
| NPI Number | 1619123056 |
|---|---|
| Provider Enumeration Date | 08/18/2008 |
| Last Update Date | 08/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619123056 | NPI | - | NPPES |
| 00119784 | Medicaid | MS | |
| 1409871 | Medicaid | LA | |
| 587948354B | Other | MS | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | (* (Not Available)) | Primary |
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