Provider Demographics
NPI:1134135916
Name:LAUGHTER, RICHARD KIM (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:KIM
Last Name:LAUGHTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 S SECOND ST STE A
Mailing Address - Street 2:
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87301-5898
Mailing Address - Country:US
Mailing Address - Phone:505-722-2923
Mailing Address - Fax:505-722-2961
Practice Address - Street 1:1500 S SECOND ST STE A
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-5898
Practice Address - Country:US
Practice Address - Phone:505-722-2923
Practice Address - Fax:505-722-2961
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2008-00552084P0800X
AZ540342084P0800X
NV119592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry