Individual
GAINES E RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 2ND ST, NEW GLARUS, WI 53574-9326
(608) 527-5296
Mailing address
1800 2ND ST, NEW GLARUS, WI 53574-9326
(608) 527-5296
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-102494
IL
207Q00000X
Family Medicine Physician
38784
WI
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
38784-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1017410
PHYSICIANS PLUS
—
01
—
11565
DEAN HEALTH PLAN
—
01
—
32399400
HIRSP
—
05
—
32399400
—
WI
01
—
390808509
WPS
—
01
—
39080850991
UNITY
—
01
—
54979
HEALTH ALLIANCE MEDICAL
—
01
—
690004890
MEDIARE RAILROAD
—
01
—
80138944
MEDICARE RAILROAD
—
01
—
90002361
WEA INS
—
Enumeration date
01/09/2007
Last updated
03/03/2021
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