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NPI Code Detail

MEDICARE: KAYLA RICHTER

MEDICARE: KAYLA RICHTER
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
1208000000XPediatrics Physician29055MS

General Provider Information

NPI Number : 1639675069
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA RICHTER
Provider Business Mailing Address
First Line : 2500 N STATE ST
Second Line :
City : JACKSON
State : MS
Zip : 39216-4500
Country : US
Telephone Number : 601-813-5634
Fax Number :
Provider Business Practice Location Address
First Line : 2500 N STATE ST
Second Line :
City : JACKSON
State : MS
Zip : 39216-4500
Country : US
Telephone Number : 601-984-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2018
Last Update Date : 03/16/2026

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Directions to “ KAYLA RICHTER ” Practice Location

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