Provider Demographics
NPI:1649448051
Name:RICHMOND FAMILY CLINIC, P.C.
Entity type:Organization
Organization Name:RICHMOND FAMILY CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN & OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:HONEYCUTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-470-2131
Mailing Address - Street 1:420 WOLLARD BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MO
Mailing Address - Zip Code:64085-1974
Mailing Address - Country:US
Mailing Address - Phone:816-470-2131
Mailing Address - Fax:816-470-7171
Practice Address - Street 1:420 WOLLARD BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MO
Practice Address - Zip Code:64085-1974
Practice Address - Country:US
Practice Address - Phone:816-470-2131
Practice Address - Fax:816-470-7171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO39627023OtherBLUE CROSS BLUE SHIELD
MO500693106Medicaid
MO500693106Medicaid