Individual
DR. BRUCE W RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10505 RIVER RD, HAVRE, MT 59501-8235
(406) 754-2266
Mailing address
PO BOX 1763, HAVRE, MT 59501-1763
(406) 394-2266
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4115
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010770
BLUE CROSS BLUE SHIELD
MT
01
—
080104909
MEDICARE RAILROAD
MT
05
—
1427020940
—
MT
Enumeration date
02/07/2006
Last updated
10/30/2013
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