Individual
JAY A RICHTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
311 WEST 14TH STREET, PUEBLO, CO 81003-2710
(719) 595-7585
(719) 595-7589
Mailing address
311 WEST 14TH STREET, PUEBLO, CO 81003-2710
(719) 595-7585
(719) 595-7589
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
26947
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01269471
—
CO
01
—
P01102035
RAILROAD MEDICARE
CO
Enumeration date
06/23/2006
Last updated
06/25/2014
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