Provider Demographics
NPI:1720368525
Name:RICHIE, DORIS ANN (RDMS, RVT)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:ANN
Last Name:RICHIE
Suffix:
Gender:F
Credentials:RDMS, RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 EAST 12TH ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72833-1029
Mailing Address - Country:US
Mailing Address - Phone:479-495-7265
Mailing Address - Fax:
Practice Address - Street 1:804 E. 12TH ST.
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:AR
Practice Address - Zip Code:72833-1029
Practice Address - Country:US
Practice Address - Phone:479-495-7265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-24
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography