Healthcare Provider Details

I. General information

NPI: 1134135916
Provider Name (Legal Business Name): RICHARD KIM LAUGHTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 457
GANADO AZ
86505-0457
US

IV. Provider business mailing address

1500 S SECOND ST STE A
GALLUP NM
87301-5898
US

V. Phone/Fax

Practice location:
  • Phone: 928-755-4933
  • Fax:
Mailing address:
  • Phone: 505-722-2923
  • Fax: 505-722-2961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD2008-0055
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number54034
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number11959
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: