Basic Information
| Provider Information | |||||||||
| NPI: | 1467985085 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RICHARDS-BOYD | ||||||||
| FirstName: | JEMESE | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 117337 | ||||||||
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| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303680001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7708012500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1615 21ST CT | ||||||||
| Address2: | |||||||||
| City: | PHENIX CITY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 368673727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3342974883 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2017 | ||||||||
| LastUpdateDate: | 08/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 40790 | AL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.