Individual
GEORGE CHARLES RICHISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2909 MILITARY RD, BENTON, AR 72015-2721
(501) 315-6500
(501) 315-0006
Mailing address
2909 MILITARY RD, BENTON, AR 72015-2721
(501) 315-6500
(501) 315-0006
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
C7143
AR
207P00000X
Emergency Medicine Physician
C-7143
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112535001
—
AR
01
—
50733
BCBS
AR
Enumeration date
06/23/2006
Last updated
06/07/2013
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