MEDICARE: DR. RICHARD L. NORTH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD23429	OR

General Provider Information

NPI Number	:	1083658611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD L. NORTH M.D.

Provider Business Mailing Address
First Line	:	605 BANNOCK ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-4505
Country	:	US
Telephone Number	:	303-436-7155
Fax Number	:

Provider Business Practice Location Address
First Line	:	605 BANNOCK ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-4505
Country	:	US
Telephone Number	:	303-436-7155
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	04/12/2016

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