Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35064391 | OH |
N | 111NI0900X | Internist | 35064391 | OH |
Y | 207RA0401X | Internist - Addiction Medicine | 35064391 | OH |
NPI | 1518907146 |
---|---|
Provider Name | Robert Timothy Richards |
First Address | Cincinnati, OH 45202-1457 |
Second Address | Columbus, OH 43213-1459 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 20/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0969448 | (05) | OH |
110112520 | RAILROAD MEDICARE PIN (01) | OH |
F74932 | (02) | OH |