Provider Demographics
NPI:1184620288
Name:RICHMOND, JAMES P JR (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:RICHMOND
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 SPRING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37412-3910
Mailing Address - Country:US
Mailing Address - Phone:423-894-1453
Mailing Address - Fax:423-899-8022
Practice Address - Street 1:932 SPRING CREEK RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412-3910
Practice Address - Country:US
Practice Address - Phone:423-894-1453
Practice Address - Fax:423-899-8022
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMDO14674207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN180006129OtherRAILROAD MEDICARE
GA000313123AMedicaid
TN0028839OtherBCBSTN
TN0028839OtherBCBSTN
TND32222Medicare UPIN
TN3199609Medicare PIN