Individual
DR. RICHARD L CONVERSE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MERCADO ST STE 130, DURANGO, CO 81301-7306
(970) 247-1120
(970) 247-1128
Mailing address
1 MERCADO ST STE 130, DURANGO, CO 81301-7306
(970) 247-1120
(970) 247-1128
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
20030692
NM
207RC0000X
Cardiovascular Disease Physician
Primary
DR.0069901
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02651858
—
NM
05
—
9000212517
—
CO
Enumeration date
10/03/2006
Last updated
03/07/2023
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