Provider Demographics
NPI:1154469922
Name:RICHARDSON-BLOUNT, DONNA E (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:E
Last Name:RICHARDSON-BLOUNT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:D
Other - Last Name:BLOUNT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1434 MORAN ROAD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069
Mailing Address - Country:US
Mailing Address - Phone:615-812-2576
Mailing Address - Fax:615-538-8738
Practice Address - Street 1:1410 17TH AVENUE SOUTH
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212
Practice Address - Country:US
Practice Address - Phone:615-297-5885
Practice Address - Fax:615-538-8738
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD208592084P0015X
TN0208592084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3812839Medicare PIN