Provider Demographics
NPI:1427889591
Name:RICHARDSON, LAKEYA (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:LAKEYA
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 AVONDALE RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-5216
Mailing Address - Country:US
Mailing Address - Phone:334-274-3942
Mailing Address - Fax:334-947-1421
Practice Address - Street 1:1120 AVONDALE RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-5216
Practice Address - Country:US
Practice Address - Phone:334-274-3942
Practice Address - Fax:334-947-1421
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN005624207ZC0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology