Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 200127 | LA |
N | 111NI0900X | Internist | 200127 | LA |
Y | 207RG0100X | Gastroenterologist | 200127 | LA |
NPI | 1013127935 |
---|---|
Provider Name | Arthur Eldridge Richert |
First Address | Monroe, LA 71201-7516 |
Second Address | Monroe, LA 71201-7516 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 10/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1065170 | (05) | LA |
20012 | MEDICAL LICENSE (01) | LA |
BR9248673 | DEA (01) | LA |