Provider Demographics
NPI:1689928046
Name:JAMES RICHARDSON MD INC
Entity Type:Organization
Organization Name:JAMES RICHARDSON MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-873-3331
Mailing Address - Street 1:307 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:CA
Mailing Address - Zip Code:93514-2603
Mailing Address - Country:US
Mailing Address - Phone:760-873-3331
Mailing Address - Fax:760-873-8567
Practice Address - Street 1:307 ACADEMY ST
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514-2603
Practice Address - Country:US
Practice Address - Phone:760-873-3331
Practice Address - Fax:760-873-8567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-06
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty