MEDICARE: MICHAEL L. RICHEY 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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	09002R	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740233543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL L. RICHEY MD

Provider Business Mailing Address
First Line	:	537 ELMER RD
Second Line	:
City	:	ELMER
State	:	LA
Zip	:	71424-9539
Country	:	US
Telephone Number	:	318-659-4947
Fax Number	:

Provider Business Practice Location Address
First Line	:	7633 BELLAIRE DR S STE 117
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4311
Country	:	US
Telephone Number	:	817-566-0663
Fax Number	:	817-346-2564

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	10/22/2008

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