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Norwood Wilbert Knight-Richardson

Psychiatry & Neurology

Allopathic & Osteopathic Physicians

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

PECOS Enrollment

This provider is enrolled in PECOS as NORWOOD KNIGHT RICHARDSON.

Based on the most recent information from CMS, provider Norwood Wilbert Knight-Richardson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1891700316
Provider Type
Individual
Full Name
Knight-Richardson, Norwood Wilbert
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
7/31/2006
Last Updated
7/8/2007

Contact Information

Practice Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

(503) 494-8617

Unlisted Fax

Mailing Location

11565 NW Mcdaniel Rd, Portland, OR 97229-4027

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2084P0800X Primary	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License MD17761 Oregon

Provider Identifiers

ID	Description	Issuer
ID 227190	Description Medicaid	Issuer Unlisted Oregon

Norwood Wilbert Knight-Richardson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Allahyar, Arrash

Kinzie, John Mark

Walker, Roger Dale

Eisenberg, Todd D

Griebeler, Meridith Amanda

Myers, Jessica Layne

Hanson, Timothy Keith

Pollack, David Alan

Thoits, Joseph Ryan

Cornejo, Brandon J