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NPI Code Detail

MEDICARE: WILLIAM R RICHARD

MEDICARE: WILLIAM R RICHARD
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
1101YA0400XAddiction (Substance Use Disorder) Counselor324LA

General Provider Information

NPI Number : 1790257269
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM R RICHARD
Provider Business Mailing Address
First Line : 2020 W PINHOOK RD STE 504
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-3212
Country : US
Telephone Number : 337-214-2100
Fax Number : 337-284-3559
Provider Business Practice Location Address
First Line : 2020 W PINHOOK RD STE 504
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-3212
Country : US
Telephone Number : 337-214-2100
Fax Number : 337-284-3559
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2018
Last Update Date : 12/21/2018

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Directions to “ WILLIAM R RICHARD ” Practice Location

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