Individual
MICHAEL BLAKE RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, DPT
Contact information
Practice address
4206 PRINCE ST, CONWAY, AR 72034-9398
(501) 499-8217
(501) 499-8227
Mailing address
4206 PRINCE ST, CONWAY, AR 72034-9398
(501) 499-8217
(501) 499-8227
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
E-19315
AR
Other
Enumeration date
09/01/2016
Last updated
01/18/2026
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