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Contact Information

BRECK T RICHARDSON, MD
332 HWY 12 WEST
KOSCIUSKO, MS39090
 Phone: 662-289-1800
 Fax: 662-289-2486
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for BRECK T RICHARDSON · (Male)

NPI Number 1962645770
Status Active
Credentials MD
Entity Individual
Enumeration date 04/08/2009
Last updated 12/11/2012 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • MS License # 21932
  • MS Medicaid 09723710
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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