Provider Demographics
NPI:1457671463
Name:WILLIAM F RICHARDS MD PLC
Entity Type:Organization
Organization Name:WILLIAM F RICHARDS MD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:M
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:WEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-383-3325
Mailing Address - Street 1:15668 COLLECTION CENTER DR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60693-0156
Mailing Address - Country:US
Mailing Address - Phone:256-383-3325
Mailing Address - Fax:256-383-5911
Practice Address - Street 1:7200 S HAZEL ST
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-7836
Practice Address - Country:US
Practice Address - Phone:870-575-0695
Practice Address - Fax:870-535-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-02
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-27742085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR184867002Medicaid
AR184867002Medicaid