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Individual
BILLY DOOGAN RICHARDSON JR.
Active
Individual
BILLY DOOGAN RICHARDSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-22073
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068002106
MEDICARE PTAN
KS
05
—
100121830E
—
KS
01
—
P00912310
RR MEDICARE - PTAN
KS
Enumeration date
08/30/2006
Last updated
09/01/2023
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