Provider Demographics
NPI:1992709745
Name:RICHARDS, ALAN B (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:B
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1400 E BERT KOUNS LOOP
Mailing Address - Street 2:SUITE #103
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5603
Mailing Address - Country:US
Mailing Address - Phone:318-222-8402
Mailing Address - Fax:318-222-4556
Practice Address - Street 1:1400 E BERT KOUNS LOOP
Practice Address - Street 2:SUITE #103
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5603
Practice Address - Country:US
Practice Address - Phone:318-222-8402
Practice Address - Fax:318-222-4556
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA05012R207W00000X
LAMD.05012R207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR129700001OtherARKANSAS MEDICAID
LA1305553Medicaid
LA180046317OtherRAILROAD MEDICARE
LA1053315846OtherGROUP NPI NUMBER
TX106524503OtherTEXAS MEDICAID
TX106524503OtherTEXAS MEDICAID
LA1305553Medicaid
LA5K7316742Medicare PIN