Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD.016683 | LA |
Y | 207VE0102X | Reproductive Endocrinologist | E-7844 | AR |
NPI | 1508812850 |
---|---|
Provider Name | Dr. Gloria Richard-Davis |
First Address | Little Rock, AR 72205-7101 |
Second Address | Little Rock, AR 72205-7101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 28/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1993506 | (05) | LA |
E72505 | (02) |