| Doctor Name: | DR. NORBERT LANCE RICHARDSON |
| NPI Number: | 1093793929 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 105672 |
| Business Practice Address: | 3933 S Broadway Saint Louis, MO - 631184601 |
| Business Phone Number: | 3148657000 |
| Business Fax Number: | 3145448305 |
| Mailing Address: | Po Box 116757, ATLANTA |
| State: | GA |
| Postal Code: | 303686757 |
| Phone Number: | 6182443322 |
| Fax Number: | |
| NPI Enumeration Date: | 12/30/2005 |
| NPI Last Update Date: | 10/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 105672 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |