Individual
JAYSON P RICHTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
46 FAIRVIEW AVE, SKOWHEGAN, ME 04976-1481
(207) 474-5121
(207) 474-3441
Mailing address
PO BOX 468, SKOWHEGAN, ME 04976-0468
(207) 474-5121
(207) 474-3441
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA1829
ME
363AM0700X
Medical Physician Assistant
Primary
PA1829
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992291538
—
ME
Enumeration date
07/06/2018
Last updated
07/03/2023
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