Provider Demographics
NPI:1609892694
Name:RICHARDS, JOSEPH J (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 E CUMBERLAND STREET
Mailing Address - Street 2:EYELAND OPTICAL
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042
Mailing Address - Country:US
Mailing Address - Phone:717-228-2020
Mailing Address - Fax:717-228-1776
Practice Address - Street 1:905 E CUMBERLAND STREET
Practice Address - Street 2:EYELAND OPTICAL
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042
Practice Address - Country:US
Practice Address - Phone:717-228-2020
Practice Address - Fax:717-228-1776
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2011-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6155T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018520410001Medicaid