IndividualActive
Charles Richardson, D.O.
NPI 1942640388 · Neurodevelopmental Disabilities Physician · Hattiesburg, MS
Provider details
- NPI number
- 1942640388
- Entity type
- Individual
- Primary specialty
- Neurodevelopmental Disabilities PhysicianAllopathic & Osteopathic Physicians
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 24662 (MS)
Practice location
2117 Broadway Drive
Hattiesburg, MS 39402-3210
Phone: (601) 288-8050
Fax: (601) 288-8058
Mailing address
2117 Broadway Drive
Hattiesburg, MS 39402-3210
Registry dates
- Enumerated
- 2013-06-30
- Last updated
- 2025-02-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.