Individual
JOHN JACKSON RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
890 E RIDGELAWN RD, MARTINSVILLE, IL 62442-2551
(217) 382-4191
(217) 382-4248
Mailing address
PO BOX 372, MATTOON, IL 61938-0372
(217) 258-2216
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-121753
IL
207Q00000X
Family Medicine Physician
11013443A
IN
Other
Enumeration date
08/05/2008
Last updated
06/14/2024
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