| John W Richardson Md Pa | |
|
2301 S Fm 51 Suite 500 Decatur TX 76234-3865 | |
| (940) 627-0013 | |
| (940) 627-1900 |
| Full Name | John W Richardson Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 2301 S Fm 51, Decatur, Texas |
| Authorized Official Name and Position | John W Richardson (PRESIDENT) |
| Authorized Official Contact | 9406270013 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John W Richardson Md Pa 2301 S Fm 51 Suite 500 Decatur TX 76234-3865 Ph: (940) 627-0013 | John W Richardson Md Pa 2301 S Fm 51 Suite 500 Decatur TX 76234-3865 Ph: (940) 627-0013 |
| NPI Number | 1376589408 |
|---|---|
| Provider Enumeration Date | 06/20/2006 |
| Last Update Date | 05/08/2023 |
| Medicare PECOS PAC ID | 1456312032 |
|---|---|
| Medicare Enrollment ID | O20041026001147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376589408 | NPI | - | NPPES |
| 168598401 | Medicaid | TX | |
| 0080QJ | Other | TX | BCBS |
| DC0267 | Other | TX | MEDICARE RAILROAD |
| Provider Name | John William Richardson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659311850 PECOS PAC ID: 0840252458 Enrollment ID: I20041027000235 |
| Provider Name | Kyle David Motsenbocker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124662028 PECOS PAC ID: 2062841125 Enrollment ID: I20200411000735 |
| Provider Name | Christi Lynne Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881277382 PECOS PAC ID: 3173922952 Enrollment ID: I20210527001206 |
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