Individual
DR. ALLEN CARL RICHERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, DEPARTMENT OF PSYCHIATRY, JACKSON, MS 39216-4500
(601) 984-5815
(601) 984-5842
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5815
(601) 984-5842
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
16011
MS
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
16011
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120748
—
MS
05
—
156867
—
AL
01
—
260043154
RAILROAD MEDICARE
MS
01
—
P01227746
RR MEDICARE PTAN
MS
Enumeration date
06/12/2006
Last updated
03/11/2014
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