Individual
KENNAN DALE RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3325 POCAHONTAS RD, BAKER CITY, OR 97814-1464
(541) 523-1797
(541) 523-1799
Mailing address
3340 E GOLDSTONE DR, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
7287
OK
207P00000X
Emergency Medicine Physician
Primary
DO214758
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/13/2020
Last updated
05/03/2023
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