Provider Demographics
NPI:1457390981
Name:RICHARDSON, JOHN B JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:B
Last Name:RICHARDSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2871 ACTON ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2560
Mailing Address - Country:US
Mailing Address - Phone:205-939-0023
Mailing Address - Fax:205-939-4180
Practice Address - Street 1:2871 ACTON ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-2560
Practice Address - Country:US
Practice Address - Phone:205-939-0023
Practice Address - Fax:205-939-4180
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2023-06-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL10976208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009978840Medicaid
AL051502732OtherBLUE CROSS - 2660 10TH AV
AL051514814OtherBLUE CROSS - 860 MONT RD
AL009960330Medicaid
AL009932891Medicaid
AL051506241OtherBLUE CROSS - 48 MED PARK
AL051514814OtherBLUE CROSS - 860 MONT RD
AL051506241OtherBLUE CROSS - 48 MED PARK