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Individual

DR. JOHN N. RICHIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 203, SHREVEPORT, LA 71118-3133
(318) 688-9955
(318) 688-9929
Mailing address
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 203, SHREVEPORT, LA 71118-3133
(318) 688-9955
(318) 688-9929

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD.010298
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1169439
LA
01
720819375711180000
TRICARE
LA
Enumeration date
12/14/2006
Last updated
07/08/2007
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