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General NPI Number Information
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NPI Number | 1144770074
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Entity Type | Organization
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Legal Business Name | CARL J RICHARD, M.D.
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Dates
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Enumeration Date | 10/04/2016
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Last Update Date | 10/04/2016
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Provider Practice Location Address
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Address Line | 204 JACKSON AVE
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City | KAPLAN
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State | LA
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Zip | 70548-3920
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Country | US
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Telephone | 337-643-8583
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Fax | 337-643-2584
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Provider Business Mailing Address
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Address Line | 204 JACKSON AVE
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City | KAPLAN
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State | LA
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Zip | 70548-3920
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING AND CODING SPECIALIST
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Name | TRACY AXTELL
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Credential |
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Telephone | 337-962-1157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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