Individual
RICHARD G. PONDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 HOSPITAL DR, COLUMBIA, MO 65201-5276
(573) 882-2568
(573) 882-2226
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2568
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2005009495
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
917558009
—
MO
Enumeration date
07/17/2006
Last updated
10/12/2011
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