Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 34056 | KY |
Y | 2081P2900X | Pain Medicine | 34056 | KY |
NPI | 1073503595 |
---|---|
Provider Name | Mrs. Gay Best Richardson |
First Address | London, KY 40741-7280 |
Second Address | London, KY 40741-7280 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2005 |
Last Update Date | 07/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64033665 | (05) | KY |
H33445 | (02) |