Healthcare Provider Details

I. General information

NPI: 1598791766
Provider Name (Legal Business Name): JAMES P. RICHARDS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N STATE ST SUITE A
HARRISVILLE MI
48740-9255
US

IV. Provider business mailing address

205 N STATE ST SUITE A
HARRISVILLE MI
48740-9255
US

V. Phone/Fax

Practice location:
  • Phone: 989-724-5655
  • Fax: 989-358-3730
Mailing address:
  • Phone: 989-724-5655
  • Fax: 989-358-3730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301049031
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: