Provider Demographics
NPI:1851383277
Name:RICHMAN, STEPHEN S (OD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:S
Last Name:RICHMAN
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 1:7051 E TANQUE VERDE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-5311
Mailing Address - Country:US
Mailing Address - Phone:520-298-3028
Mailing Address - Fax:520-298-0705
Practice Address - Street 1:7051 E TANQUE VERDE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-5311
Practice Address - Country:US
Practice Address - Phone:520-298-3028
Practice Address - Fax:520-298-0705
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ193152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ035247Medicaid
AZT76798Medicare UPIN