Travis D Richardson, DO, PLLC

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

E4201 Issued in AR

Legal business name

TRAVIS D RICHARDSON, DO, PLLC

Practice address

555 W 6TH St
Mountain Home, AR 72653-3409

Phone

(870) 424-4507

Fax

(870) 425-4546

NPI assigned

Nov 30, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Travis Dale Richardson, DO

Title

President

Phone

(870) 424-4507

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1265614309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1677",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726541677",
            "telephone_number": "870-424-4507",
            "fax_number": "870-425-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W 6TH ST",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533409",
            "telephone_number": "870-424-4507",
            "fax_number": "870-425-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAVIS D RICHARDSON, DO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-424-4507",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "AR",
            "license": "E4201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.