MEDICARE: DR. RICHARD WELDON HONSINGER JR. MD

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	207K00000X	Allergy & Immunology Physician	6712	NM

General Provider Information

NPI Number	:	1710982681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD WELDON HONSINGER JR. MD

Provider Business Mailing Address
First Line	:	3917 WEST RD
Second Line	:	SUITE 150
City	:	LOS ALAMOS
State	:	NM
Zip	:	87544
Country	:	US
Telephone Number	:	505-662-4351
Fax Number	:	505-662-4351

Provider Business Practice Location Address
First Line	:	3917 WEST RD
Second Line	:	SUITE 150
City	:	LOS ALAMOS
State	:	NM
Zip	:	87544
Country	:	US
Telephone Number	:	505-662-4351
Fax Number	:	505-662-4351

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	11/23/2009

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