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Organization
TREVOR RICHARD MD APMC
Active
Organization
TREVOR RICHARD MD APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TREVOR C RICHARD M.D. (PROVIDER)
(318) 518-6091
Entity
Organization
Contact information
Practice address
2525 VIKING DR, BOSSIER CITY, LA 71111-2103
(318) 747-5377
Mailing address
4855 AIRLINE DR, BOSSIER CITY, LA 71111-6600
(318) 747-5377
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
202291
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1079464
—
LA
Enumeration date
03/10/2010
Last updated
04/28/2010
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