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1902081813
JASON P RICHARDS
POCATELLO, ID
NPI
1902081813
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207XX0005X Orthopaedic Surgery Sports Medicine
(Licence: CA A120201)
Enumeration Date
2008-01-09
Last Update Date
2021-12-06
Business Address
DR. JASON P RICHARDS MD
2240 E CENTER ST
POCATELLO, ID 83201
Phone number: 208-233-8344
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Mailing Address
DR. JASON P RICHARDS MD
393 E WALNUT ST PHR GROUP PROVIDER ENROLLMENT UNIT, 3RD FL
PASADENA, CA 91188-0001
Phone number: 626-405-7914
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