Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 887 | AR |
NPI | 1003826850 |
---|---|
Provider Name | Richard Riley |
First Address | Little Rock, AR 72201-2008 |
Second Address | Little Rock, AR 72201-2008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 23/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
14434000040 | QUALCHOICE (01) | AR |
350022129 | RAID ROAD MEDICARE (01) | |
59798 | BLUE ADVANTAGE (01) | AR |
59798 | BLUE CROSS/BLUE SHIELD (01) | AR |
59798 | FIRST SOURCE (01) | AR |
59798 | HEALTH ADVANTAGE (01) | AR |