Doctor Name: | JEFFREY G RICHMOND |
NPI Number: | 1184699688 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 16775 |
Business Practice Address: | 2940 E Banner Gateway Dr Suite 450 Gilbert, AZ - 85234 |
Business Phone Number: | 4802563676 |
Business Fax Number: | 4802563608 |
Mailing Address: | 2940 E Banner Gateway Dr, Suite 450 GILBERT |
State: | AZ |
Postal Code: | 85234 |
Phone Number: | 4802563676 |
Fax Number: | 4802563608 |
NPI Enumeration Date: | 02/20/2006 |
NPI Last Update Date: | 01/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 16775 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AZ |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |