Individual
DR. CHARLOTTE JEAN RICHARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1896 E BABBIT LANE, SAN LUIS, AZ 85349-1669
(928) 722-6112
(928) 722-6113
Mailing address
PO BOX 617, SOMERTON, AZ 85350-0617
(928) 662-0406
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
59904
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
626655
—
AZ
01
—
Z92837
MEDICARE PTAN
AZ
Enumeration date
04/26/2006
Last updated
08/13/2024
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