Individual
DR. SAMUEL MILTON RICHARDSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
Mailing address
831 WEST DEERFIELD, CANTON, MS 39046
(601) 898-9832
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
08991
MS
Other
Enumeration date
07/10/2006
Last updated
10/22/2011
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