Individual
KENNETH RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
210 N MARKET ST, MILAN, MO 63556-1316
(660) 265-4456
(660) 265-4627
Mailing address
210 N MARKET ST, MILAN, MO 63556-1316
(660) 265-4456
(660) 265-4627
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
109328
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
248220519
—
MO
Enumeration date
10/11/2006
Last updated
12/18/2020
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