Organization
JASON P RICHARDS MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON P RICHARDS MD (OWNER)
(208) 233-8344
Entity
Organization
Contact information
Practice address
444 HOSPITAL WAY STE 477, POCATELLO, ID 83201-2744
(208) 233-8344
(208) 233-6983
Mailing address
444 HOSPITAL WAY STE 477, POCATELLO, ID 83201-2744
(208) 233-8344
(208) 233-6983
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
M12138
ID
Other
Enumeration date
08/16/2013
Last updated
08/16/2013
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