Provider Demographics
NPI:1518490341
Name:RICHARDSON, BROOKS (MD)
Entity type:Individual
Prefix:
First Name:BROOKS
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 NICHOLASVILLE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1412
Mailing Address - Country:US
Mailing Address - Phone:859-260-5051
Mailing Address - Fax:859-260-5052
Practice Address - Street 1:1780 NICHOLASVILLE RD STE 202
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1412
Practice Address - Country:US
Practice Address - Phone:859-260-5051
Practice Address - Fax:859-260-5052
Is Sole Proprietor?:No
Enumeration Date:2017-04-08
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY56518207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology