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General NPI Number Information
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NPI Number | 1366975252
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Entity Type | Individual
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Provider Name | AMY RICHMOND M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/06/2017
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 6 13TH AVE E
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City | POLSON
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State | MT
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Zip | 59860-5315
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Country | US
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Telephone | 406-883-8420
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Fax |
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Provider Business Mailing Address
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Address Line | 445 W ALDER ST
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City | MISSOULA
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State | MT
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Zip | 59802-4121
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Country | US
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Telephone | 406-510-1800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MED-PHYS-LIC-89092
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License Number State | MT
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