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Individual

DR. RICHARD THOMAS SHIMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2770 3RD AVE STE 120, LAKE CHARLES, LA 70601-8994
(337) 494-4868
(337) 494-4870
Mailing address
PO BOX 122342 DEPT 2342, DALLAS, TX 75312-0001
(337) 494-2921
(337) 494-6523

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
14655R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1140872
LA
01
MD.14655R
STATE MEDICAL LICENSE
LA
Enumeration date
02/25/2006
Last updated
04/28/2022
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