Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Michael Blake Richardson, MD, DPT

Individual provider Dermatology Physician · NPI 1114474723

Michael Blake Richardson, MD, DPT is a Dermatology in Conway, Arkansas. Graduated from University of Arkansas College of Medicine in 2021, 5 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Arkansas.

Years since qualifying
5
Trained at
University of Arkansas College of Medicine
Licensed in
AR
In the registry since
2016
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

4206 Prince St
Conway, AR 72034-9398
Phone: (501) 499-8217
Fax: (501) 499-8227
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence E-19315 (AR)

Record details

NPI number1114474723
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , DPT
Sole proprietorYes
NPI enumeratedSeptember 1, 2016
Last updated in NPPESJanuary 18, 2026
Certification dateJanuary 18, 2026
Mailing address4206 Prince St, Conway, AR 72034-9398

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolUNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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