Provider Demographics
NPI:1003817230
Name:FOSTER, RICHARD W (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:W
Last Name:FOSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 98509
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70884-9509
Mailing Address - Country:US
Mailing Address - Phone:225-769-2200
Mailing Address - Fax:225-768-2185
Practice Address - Street 1:10101 PARK ROWE AVE STE 200
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-1685
Practice Address - Country:US
Practice Address - Phone:225-769-2200
Practice Address - Fax:225-768-2185
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN184842085N0700X, 2085R0202X
VA01010329022085N0700X, 2085R0202X
LAMD.07009R2085R0202X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10032521OtherSENTARA
227701063OtherCHAMPUS
WV0216612000Medicaid
TN3058520OtherBCBS
KY64758959Medicaid
LAP00797176OtherMEDICARE, RAILROAD
NC890508TMedicaid
VA202043OtherANTHEM BCBS
TN3035792Medicaid
300066639OtherPGBA (RR MEDICARE)
TNR07104OtherJOHN DEERE
VA10032521OtherOPTIMA
VA1003817230Medicaid
VA7213352Medicaid
TN3058520OtherBCBS
227701063OtherCHAMPUS
3035792Medicare ID - Type Unspecified
VA10032521OtherOPTIMA