| Doctor Name: | DR. RICHARD JAMES SERKOWSKI |
| NPI Number: | 1174502090 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO, MPH |
| License Number: | 42767-021 |
| Business Practice Address: | 511 N Torch Blvd Bldg 300 Cannon Afb, NM - 881035109 |
| Business Phone Number: | 5757840287 |
| Business Fax Number: | |
| Mailing Address: | 511 N Torch Blvd, Bldg 300 CANNON AFB |
| State: | NM |
| Postal Code: | 881035109 |
| Phone Number: | 5757840287 |
| Fax Number: | |
| NPI Enumeration Date: | 01/10/2006 |
| NPI Last Update Date: | 08/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 42767-021 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |