Individual
KEVIN A RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
502 ELM ST NE, ALBUQUERQUE, NM 87102-2512
(505) 841-1000
(505) 843-2592
Mailing address
502 ELM ST NE, ALBUQUERQUE, NM 87102-2512
(505) 841-1000
(505) 843-2956
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
0101287810
VA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
036125892
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
2001-290
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618941
BLUECROSS BLUESHIELD
IL
05
—
036125892
—
IL
05
—
J1459
—
NM
Enumeration date
06/08/2005
Last updated
01/02/2026
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