Provider Demographics
NPI:1386239572
Name:RICHARDSON, HAYDEN MCCARTHY (DV)
Entity type:Individual
Prefix:DR
First Name:HAYDEN
Middle Name:MCCARTHY
Last Name:RICHARDSON
Suffix:
Gender:M
Credentials:DV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4319 COVINGTON HWY STE 201
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-1206
Mailing Address - Country:US
Mailing Address - Phone:678-505-0000
Mailing Address - Fax:
Practice Address - Street 1:4319 COVINGTON HWY STE 201
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-1206
Practice Address - Country:US
Practice Address - Phone:678-505-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010476111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor