Provider Demographics
NPI:1811342066
Name:RICHARDSON, TADARRO LEE JR (MD)
Entity type:Individual
Prefix:DR
First Name:TADARRO
Middle Name:LEE
Last Name:RICHARDSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:391 OMAN ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1285
Mailing Address - Country:US
Mailing Address - Phone:859-684-0168
Mailing Address - Fax:
Practice Address - Street 1:1955 DIXIE HWY STE E
Practice Address - Street 2:
Practice Address - City:FT WRIGHT
Practice Address - State:KY
Practice Address - Zip Code:41011-2882
Practice Address - Country:US
Practice Address - Phone:859-292-4560
Practice Address - Fax:859-292-4561
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN60767207R00000X
OH35151712207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine