Healthcare Provider Details

I. General information

NPI: 1457521163
Provider Name (Legal Business Name): DR RICHARD K AKIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2008
Last Update Date: 03/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1013 HIGHWAY 90
BAY SAINT LOUIS MS
39520-1524
US

IV. Provider business mailing address

1013 HIGHWAY 90
BAY SAINT LOUIS MS
39520-1524
US

V. Phone/Fax

Practice location:
  • Phone: 228-467-4229
  • Fax: 228-467-4354
Mailing address:
  • Phone: 228-467-4229
  • Fax: 228-467-4354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD K AKIN
Title or Position: OWNER
Credential: DDS
Phone: 228-467-4229