Individual
DR. RICHARD B SOUTHWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1909 VISTA DR, LARAMIE, WY 82070-5530
(307) 745-8851
(307) 742-0961
Mailing address
1909 VISTA DR, LARAMIE, WY 82070-5530
(307) 745-8851
(307) 742-0961
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
3077A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100342900
—
WY
01
—
200009950
RAILROAD MEDICARE
—
01
—
305410
BCBS
—
Enumeration date
01/18/2006
Last updated
06/12/2009
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