Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 20574 | NE |
Y | 208200000X | Surgeon | 20574 | NE |
Y | 208600000X | Surgeon | 20574 | NE |
NPI | 1003871591 |
---|---|
Provider Name | Dr. Alan T. Richards |
First Address | Virginia Beach, VA 23450-0190 |
Second Address | Omaha, NE 68114-4108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 01/07/2014 |