Provider Demographics
NPI:1285671578
Name:RICHARDSON, ROBERT FRANK JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FRANK
Last Name:RICHARDSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:88 CENTER RD STE 230
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-2708
Mailing Address - Country:US
Mailing Address - Phone:440-735-4264
Mailing Address - Fax:440-735-4263
Practice Address - Street 1:88 CENTER RD STE 230
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-2708
Practice Address - Country:US
Practice Address - Phone:440-735-4264
Practice Address - Fax:440-735-4263
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350693172084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2125604Medicaid
341876866OtherPRACTICE TAX ID NUMBER
OH2125604Medicaid
RO0882231Medicare ID - Type Unspecified