Provider Demographics
NPI:1558469981
Name:RICHARDSON, ALBERT I II (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:I
Last Name:RICHARDSON
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1019 E JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-4789
Mailing Address - Country:US
Mailing Address - Phone:229-236-6742
Mailing Address - Fax:229-236-6746
Practice Address - Street 1:1019 E JACKSON ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-4789
Practice Address - Country:US
Practice Address - Phone:229-236-6742
Practice Address - Fax:229-236-6746
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA055328208600000X
GA553282086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery