Richardson, Breck T
Richardson, Breck T is an individual health care provider with primary practice located at 332 Hwy 12 West , Kosciusko MS 39090. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Richardson, Breck T can be contacted via phone (662) 289-1800.Contact Information
Primary practice address
332 Hwy 12 West
Kosciusko MS 39090
Phone: (662) 289-1800
Fax: (662) 289-2486
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 21932 | Mississippi |
Profile Details
| NPI number | 1962645770 |
|---|---|
| LBN Legal business name | Richardson, Breck T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 8th, 2009 |
| Last updated | Dec 11th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962645770 | NPPES |
| Mississippi | MEDICAID | 09723710 |
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