| Richardson Family Medicine Prof Llc | |
|
625 W 18th St Sioux Falls SD 57105 | |
| (605) 275-8800 | |
| (605) 338-7890 |
| Full Name | Richardson Family Medicine Prof Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 625 W 18th St, Sioux Falls, South Dakota |
| Authorized Official Name and Position | James Richardson (PRESIDENT) |
| Authorized Official Contact | 6052758800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richardson Family Medicine Prof Llc 625 W 18th St Sioux Falls SD 57105 Ph: (605) 275-8800 | Richardson Family Medicine Prof Llc 625 W 18th St Sioux Falls SD 57105 Ph: (605) 275-8800 |
| NPI Number | 1689856429 |
|---|---|
| Provider Enumeration Date | 12/04/2007 |
| Last Update Date | 03/30/2011 |
| Medicare PECOS PAC ID | 9234161472 |
|---|---|
| Medicare Enrollment ID | O20050908000401 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689856429 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3456 (South Dakota) | Primary |
| Provider Name | James L Richardson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528080371 PECOS PAC ID: 2769414903 Enrollment ID: I20050909000395 |
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