Provider Demographics
NPI:1528080371
Name:RICHARDSON, JAMES (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:625 W 18TH ST
Mailing Address - Street 2:RICHARDSON FAMILY PRACTICE LLC
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105
Mailing Address - Country:US
Mailing Address - Phone:605-275-8800
Mailing Address - Fax:605-338-7890
Practice Address - Street 1:625 W 18TH ST
Practice Address - Street 2:RICHARDSON FAMILY PRACTICE LLC
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105
Practice Address - Country:US
Practice Address - Phone:605-275-8800
Practice Address - Fax:605-338-7890
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2008-02-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SD3456207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5607028Medicaid
SD5607028Medicaid
F07422Medicare UPIN