MEDICARE: DR. RICHARD M HARRELL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	019429	LA

General Provider Information

NPI Number	:	1346244209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD M HARRELL MD

Provider Business Mailing Address
First Line	:	2508 BERT KOUNS INDUSTRIAL LOOP STE 200
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71118-3166
Country	:	US
Telephone Number	:	318-212-5044
Fax Number	:	318-212-5049

Provider Business Practice Location Address
First Line	:	2508 BERT KOUNS INDUSTRIAL LOOP STE 200
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71118-3166
Country	:	US
Telephone Number	:	318-212-5044
Fax Number	:	318-212-5049

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	06/03/2025

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