Paddock, Richard J

Paddock, Richard J is an individual health care provider with primary practice located at 1340 Broad Ave Suite 210, Gulfport MS 39501. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Paddock, Richard J can be contacted via phone (228) 575-1600.

Contact Information

Primary practice address
1340 Broad Ave Suite 210 Gulfport MS 39501
Phone: (228) 575-1600
Fax: (228) 575-1603
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 015310 Louisiana
Allopathic & Osteopathic Physicians / Urology 208800000X 32690 Mississippi

Profile Details

NPI number 1679565428
LBN Legal business name Paddock, Richard J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2005
Last updated Feb 15th, 2024 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679565428 NPPES
Louisiana MEDICAID 1335169

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