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General NPI Number Information
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NPI Number | 1164483426
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Entity Type | Organization
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Legal Business Name | MARY K RICHARDS MD PA
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 09/28/2007
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Provider Practice Location Address
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Address Line | 5800 W 10TH ST SUITE 600
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City | LITTLE ROCK
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State | AR
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Zip | 72204-1755
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Country | US
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Telephone | 501-666-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 5800 W 10TH ST SUITE 600
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City | LITTLE ROCK
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State | AR
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Zip | 72204-1755
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Country | US
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Telephone | 501-666-5000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARY K RICHARDS
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Credential |
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Telephone | 501-666-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | C5156
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License Number State | AR
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