Organization
TRAVIS D. RICHARDSON, D.O. PLC
Active
Organization
TRAVIS D. RICHARDSON, D.O. PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRAVIS D RICHARDSON D.O. (DOCTOR OF OSTEOPATHIC MEDICINE)
(870) 239-8102
Entity
Organization
Contact information
Practice address
1507 LINWOOD DR STE A, PARAGOULD, AR 72450-5818
(870) 239-8102
(870) 239-8105
Mailing address
1507 LINWOOD DR STE A, PARAGOULD, AR 72450-5818
(870) 239-8102
(870) 239-8105
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
E4201
AR
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219624004
—
AR
05
—
238889716
—
AR
Enumeration date
08/15/2014
Last updated
04/24/2020
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