Individual
RICHARD A LAUDERDALE JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
400 TAYLOR RD, MONTGOMERY, AL 36117-3512
(334) 272-1050
(818) 587-2493
Mailing address
301 BROWN SPRINGS RD, MONTGOMERY, AL 36117-7005
(334) 273-4508
(334) 273-4290
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA151
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051556080
—
AL
Enumeration date
05/16/2006
Last updated
12/28/2015
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