Provider Demographics
NPI:1679803530
Name:KINDER, RICHARD GENE (PA-C)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:GENE
Last Name:KINDER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:MEDICINE BOW
Mailing Address - State:WY
Mailing Address - Zip Code:82329-0037
Mailing Address - Country:US
Mailing Address - Phone:307-379-2222
Mailing Address - Fax:307-379-2223
Practice Address - Street 1:514 IDAHO DR
Practice Address - Street 2:
Practice Address - City:MEDICINE BOW
Practice Address - State:WY
Practice Address - Zip Code:82329-5017
Practice Address - Country:US
Practice Address - Phone:307-379-2222
Practice Address - Fax:307-379-2223
Is Sole Proprietor?:No
Enumeration Date:2009-12-28
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY279363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical