Provider Demographics
NPI:1134191042
Name:RICHARDSON, DELPHIS C (MD)
Entity type:Individual
Prefix:DR
First Name:DELPHIS
Middle Name:C
Last Name:RICHARDSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6301 S MCCLINTOCK DR
Mailing Address - Street 2:#101
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3392
Mailing Address - Country:US
Mailing Address - Phone:480-214-2300
Mailing Address - Fax:480-214-2301
Practice Address - Street 1:6301 S MCCLINTOCK DR
Practice Address - Street 2:#101
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3392
Practice Address - Country:US
Practice Address - Phone:480-214-2300
Practice Address - Fax:480-214-2301
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ21881208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ021881OtherMAYO INSURANCE
AZ1338270OtherDEPT. OF ECONOMIC SECURIT
AZ133827Medicaid
AZAZ0343880OtherBLUE CROSS BLUE SHIELD
AZ00014253OtherBANNER HEALTH PLAN
AZ1Z2123OtherHEALTHNET