Individual
DR. JASON D RICHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1801 E MAIN ST, CHARLESTON, AR 72933-9254
(479) 963-2132
(479) 963-2046
Mailing address
PO BOX 3528, FORT SMITH, AR 72913-3528
(479) 274-2000
(479) 274-2194
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-1475
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080137586
RR MEDICARE
—
05
—
132775001
—
AR
Enumeration date
07/24/2006
Last updated
09/01/2015
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