Basic Information
| Provider Information | |||||||||
| NPI: | 1932554086 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RICHARDSON | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | ALEXANDER | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 SIVLEY RD SW STE 500 | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358015177 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2562653880 | ||||||||
| FaxNumber: | 2562653886 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 SIVLEY RD SW STE 500 | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358015177 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2562653880 | ||||||||
| FaxNumber: | 2562653886 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2016 | ||||||||
| LastUpdateDate: | 04/26/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 1-106447 | AL | Y | Hospitals | General Acute Care Hospital |
No ID Information.