Provider Demographics
NPI:1205063872
Name:TODD A. RICHARDSON D.C. P.A.
Entity type:Organization
Organization Name:TODD A. RICHARDSON D.C. P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-427-2990
Mailing Address - Street 1:727 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-4935
Mailing Address - Country:US
Mailing Address - Phone:302-427-2990
Mailing Address - Fax:302-427-2994
Practice Address - Street 1:727 N MARKET ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-4935
Practice Address - Country:US
Practice Address - Phone:302-427-2990
Practice Address - Fax:302-427-2994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000658111N00000X
DEF1-0000462111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2102080OtherUNITED HEALTH CARE
2420880000OtherAMERIHEALTH HMO
2882144OtherAETNA HMO
2102080OtherMAMSI
326083OtherCOVENTRY
510392121OtherBLUE CROSS BLUE SHEILD OF DELAWARE
1755641OtherAMERIHEALTH PPO
7098137OtherAETNA PPO
DEV03346Medicare UPIN