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Individual

DR. JOHN J RICHARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1008 JENKS AVE, PANAMA CITY, FL 32401-2437
(850) 215-3000
(850) 215-3150
Mailing address
1008 JENKS AVE, PANAMA CITY, FL 32401-2437
(850) 215-3000
(850) 215-3150

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME60114
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0042653000
FL
01
051555890
MEDICARE PROVIDER #
AL
01
102I023970
MEDICARE GROUP/ PROVIDER PTAN
AL
05
114684
AL
01
12421
BLUE CROSS
FL
05
608500
FL
01
678471
WELLCARE
FL
01
C70352
UPIN
AL
Enumeration date
11/14/2005
Last updated
03/11/2016
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