Southwell, Richard B

Southwell, Richard B is an individual health care provider with primary practice located at 1909 Vista Dr , Laramie WY 82070-5530. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Southwell, Richard B can be contacted via phone (307) 745-8851.

Contact Information

Primary practice address
1909 Vista Dr Laramie WY 82070-5530
Fax: (307) 742-0961
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 3077A Wyoming

Profile Details

NPI number 1265412225
LBN Legal business name Southwell, Richard B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2006
Last updated Jun 12th, 2009 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265412225 NPPES
Wyoming MEDICAID 100342900
Wyoming Other 200009950
Wyoming Other 305410

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