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Individual

MR. RICHARD R LAUDERDALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
420 SOUTH 7TH STREET, OAKES, ND 58474-2024
(701) 742-3267
(701) 742-3201
Mailing address
PO BOX 50, OAKES, ND 58474-0050
(701) 742-3267
(701) 742-3201

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAC0054
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18895
BLUE SHIELD
ND
01
CF8850
RAILROAD MEDICARE
ND
Enumeration date
07/04/2006
Last updated
05/21/2008
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