Individual
SCOTT KENCHILOE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
605 PARFET ST, # 103, LAKEWOOD, CO 80215-5576
(303) 758-2800
Mailing address
4555 OTTAWA PLACE, BOULDER, CO 80303
(303) 494-5588
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
27137
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01271378
—
CO
05
—
26701316
—
CO
Enumeration date
06/28/2006
Last updated
09/02/2009
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