| Doctor Name: | JEFFREY RICHARD |
| NPI Number: | 1356769111 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | MD-17111 |
| Business Practice Address: | 150 Kendall St S Battle Creek, MI - 490378471 |
| Business Phone Number: | 2694414141 |
| Business Fax Number: | 2694414142 |
| Mailing Address: | 150 Kendall St S, BATTLE CREEK |
| State: | MI |
| Postal Code: | 490378471 |
| Phone Number: | 2694414141 |
| Fax Number: | 2694414142 |
| NPI Enumeration Date: | 03/30/2014 |
| NPI Last Update Date: | 07/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD-17111 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | HI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |