Richardson, Cory Glen
Richardson, Cory Glen is an sole proprietor health care provider with primary practice located at 750 N Syringa St Ste 205 , Post Falls ID 83854-5275. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Richardson, Cory Glen can be contacted via phone (208) 262-0945.Contact Information
Primary practice address
750 N Syringa St Ste 205
Post Falls ID 83854-5275
Phone: (208) 262-0945
Fax: (208) 425-0150
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | M-13357 | Idaho |
Profile Details
| NPI number | 1295050342 |
|---|---|
| LBN Legal business name | Richardson, Cory Glen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 1st, 2010 |
| Last updated | Aug 11th, 2022 - about 4 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 | 1295050342 | NPPES |
| Idaho | MEDICAID | 1295050342 |
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