Individual
DR. JOHN PORTER RICHARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4710 CHIMNEY DR STE H, CHARLESTON, WV 25302-4841
(304) 935-2513
(304) 935-2524
Mailing address
4710 CHIMNEY DR STE H, CHARLESTON, WV 25302-4841
(304) 935-2513
(304) 935-2524
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1129
WV
208100000X
Physical Medicine & Rehabilitation Physician
1129
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001721126
BC/BS
WV
05
—
0041905000
—
WV
01
—
004361690
AETNA
WV
01
—
1025208
WORKER'S COMPENSATION
WV
01
—
110028670
RAILROAD MEDICARE
WV
01
—
205562
CARELINK COVENTRY
WV
01
—
224826100
US DEPT OF LABOR
WV
01
—
550694936
UNITED HEALTHCARE MAMSI
WV
01
—
7152313
CIGNA
WV
Enumeration date
04/08/2006
Last updated
09/13/2023
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