Individual
THOMAS RICHARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
557 W WASHINGTON ST, BURNS, OR 97720-1441
(541) 573-7281
Mailing address
334 SUSAN DR., MOSCOW, ID 83843-9482
(208) 596-1662
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD15123
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1201778
—
WY
05
—
156158
—
OR
05
—
80649700
—
ID
05
—
8300121
—
WA
01
—
P00059941
RR MEDICARE
—
Enumeration date
04/18/2007
Last updated
07/08/2007
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