Provider Demographics
NPI:1013127935
Name:RICHERT, ARTHUR ELDRIDGE (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:ELDRIDGE
Last Name:RICHERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ARTHUR
Other - Middle Name:
Other - Last Name:RICHERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:611 GRAMMONT ST.
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-7516
Mailing Address - Country:US
Mailing Address - Phone:318-325-2634
Mailing Address - Fax:318-812-1205
Practice Address - Street 1:611 GRAMMONT ST.
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7516
Practice Address - Country:US
Practice Address - Phone:318-325-2634
Practice Address - Fax:318-812-1205
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200127207RG0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1065170Medicaid
LA20012OtherMEDICAL LICENSE
LA20012OtherMEDICAL LICENSE
LA1065170Medicaid