Keenan Glen Richardson
MD | Pediatrics | Male
Keenan Glen Richardson, MD is a Minnetonka, Minnesota based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Keenan Glen Richardson is
17705 Hutchins Dr, Minnetonka, Minnesota - 55345-4145. He can be contacted on phone at
952-401-8300.
Keenan Glen Richardson is a sole proprietor of his business.
NPI number (Unique professional ID) for Keenan Glen Richardson is
1700858800 which was assigned by NPPES on 02 Feb, 2006 and it was last updated on 09 Jul, 2007.
Keenan Glen Richardson license number is
27968 for Pediatrics (208000000X) in Minnesota.
Keenan Glen Richardson is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Keenan Glen Richardson basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Keenan Glen Richardson |
|---|
| Credential : | MD |
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| Gender : | Male |
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Business Address:
Keenan Glen Richardson address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 17705 Hutchins Dr
Minnetonka, MN, 55345-4145
United States |
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| Phone Number : | 952-401-8300 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1700858800 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 02 Feb, 2006 |
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| Last Updated On : | 09 Jul, 2007 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Keenan Glen Richardson are as mentioned. Primary taxonomy code for Keenan Glen Richardson, MD is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 27968 | MN |
Legacy Identifiers:
Other legacy medical identifiers of Keenan Glen Richardson such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 1200786 | Other | MN | MEDICA |
| 020K3RI | Other | MN | BCBSOFMN |
| 114509 | Other | MN | UCARE |
| CP9040209014 | Other | MN | PREFERREDONE |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 17705 Hutchins Dr Ste 101
Minnetonka, MN, 55345-4102
United States |
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| Phone Number : | 952-401-8300 |
|---|
Business Location:
Patients can refer following map for directions to
Keenan Glen Richardson practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.