Organization
TRAVIS D RICHARDSON, DO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRAVIS DALE RICHARDSON DO (PRESIDENT)
(870) 424-4507
Entity
Organization
Contact information
Practice address
555 W 6TH ST, MOUNTAIN HOME, AR 72653-3409
(870) 424-4507
(870) 425-4546
Mailing address
PO BOX 1677, MOUNTAIN HOME, AR 72654-1677
(870) 424-4507
(870) 425-4546
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
E4201
AR
Other
Enumeration date
11/30/2007
Last updated
11/30/2007
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