Individual
DR. PHILLIP DAVID RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDH, DOM
Contact information
Practice address
717 ENCINO PLACE NE SUITE 7, ALBUQUERQUE, NM 87102
(505) 843-9636
(505) 843-6277
Mailing address
717 ENCINO PLACE NE SUITE 7, ALBUQUERQUE, NM 87102
(505) 843-9636
(505) 843-6277
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
800
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OORJ13
BLUE CROSS BLUE SHIELD
NM
Enumeration date
07/28/2006
Last updated
07/08/2007
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