DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. BAXTER KEY RICHARDSON IV, MD

Active Sole Proprietor

DR. BAXTER KEY RICHARDSON IV, MD is a Diagnostic Radiology healthcare provider located in JACKSON, California. NPI 1306109905 is currently active in the NPPES registry. Verify at CMS.

Diagnostic Radiology · JACKSON, CA

Registration Details

NPI Number
1306109905
Provider Type
Individual
Gender
Male
NPI Issued
Jun 19, 2012 (14.168490029881 yrs)
Last Updated
Jun 9, 2022
Licenses
R9512 (IA)
A148942 (CA)
Sole Proprietor
Yes

Practice Information

Address
200 MISSION BLVD
JACKSON, CA, 956422564
Browse CA providers · Browse ZIP 95642
Phone
2092237560
Primary Specialty
Diagnostic Radiology
2085R0202X
Additional Specialty
Diagnostic Radiology

Other Diagnostic Radiology Providers in JACKSON, CA

Name Credential NPI
SEAN KELLEY M.D. 1194144170
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.