Individual
DR. BAXTER KEY RICHARDSON IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 MISSION BLVD, JACKSON, CA 95642-2564
(209) 223-7560
Mailing address
PO BOX 5617, SAGINAW, MI 48603-0617
(209) 262-1845
(989) 401-4245
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R9512
IA
2085R0202X
Diagnostic Radiology Physician
Primary
A148942
CA
Other
Enumeration date
06/19/2012
Last updated
06/09/2022
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