Individual
CHARLES KEITH RICHARD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5825 AIRLINE HWY, BATON ROUGE, LA 70805-2408
(318) 840-3800
Mailing address
5825 AIRLINE HIGHWAY, BATON ROUGE, LA 70805
(318) 840-3800
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
205076
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2009
Last updated
02/15/2012
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