1700996188 NPI number — RICHARD DONALD SAXBY III DPM

Table of content: RICHARD DONALD SAXBY III DPM (NPI 1700996188)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700996188 NPI number — RICHARD DONALD SAXBY III DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAXBY
Provider First Name:
RICHARD
Provider Middle Name:
DONALD
Provider Name Prefix Text:
Provider Name Suffix Text:
III
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700996188
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4209
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IRONTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45638-4209
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-532-3611
Provider Business Mailing Address Fax Number:
740-532-5077

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2004 SOUTH 4TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRONTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45638
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-532-3611
Provider Business Practice Location Address Fax Number:
740-532-5077
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  36002873S , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000041976 . This is a "ANTHEM KY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31143306900 . This is a "WORKERS COMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: G321 . This is a "BCBS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 8205130 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0133715 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 80000177 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001715086 . This is a "MOUNTAIN STATE BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2780354 . This is a "UHC OF OHIO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 311580933001 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000041976 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 480024301 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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