Provider Demographics
NPI:1457427213
Name:MOREHEAD, RICHARD MANNING JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MANNING
Last Name:MOREHEAD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3 LADERA RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87508-2109
Mailing Address - Country:US
Mailing Address - Phone:505-466-2426
Mailing Address - Fax:505-466-3638
Practice Address - Street 1:3 LADERA RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87508-2109
Practice Address - Country:US
Practice Address - Phone:505-466-2426
Practice Address - Fax:505-466-3638
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG227422085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology