Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Charles D Richardson, MD

Individual provider Family Medicine Physician · NPI 1619105236

Charles D Richardson, MD is a Family Practice in Ogden, Utah. Qualified in 2008, 18 years ago. Practices with Tanner Memorial Clinic, a 252-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
18
Licensed in
UT
In the registry since
2009
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4403 Harrison Blvd Ste 700A
Ogden, UT 84403-3295
Phone: (801) 387-5300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 74194651205 (UT)

Record details

NPI number1619105236
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 23, 2009
Last updated in NPPESDecember 2, 2009
Mailing addressPo Box 27128, Salt Lake City, UT 84127-0128

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Tanner Memorial Clinic — 252 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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