Individual
DR. MARK RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
777 HOSPITAL WAY, SUITE 101, POCATELLO, ID 83201-5175
(208) 239-3899
(208) 232-2195
Mailing address
P.O. BOX 4168, POCATELLO, ID 83205-4168
(208) 239-1035
(208) 239-3626
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
2001013144
MO
207RC0000X
Cardiovascular Disease Physician
35092278
OH
207RC0000X
Cardiovascular Disease Physician
4301090962
MI
207RC0001X
Clinical Cardiac Electrophysiology Physician
35092778
OH
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
M-16034
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00751126
RAILROAD MEDICARE
—
Enumeration date
07/12/2006
Last updated
09/10/2025
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