Provider Demographics
NPI:1033167705
Name:WEPSIC, RICHARD A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:WEPSIC
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 1:4015 GATEWAY BLVD STE 2120
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8925
Mailing Address - Country:US
Mailing Address - Phone:812-842-0907
Mailing Address - Fax:812-464-4485
Practice Address - Street 1:520 MARY ST.
Practice Address - Street 2:SUITE 230
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1678
Practice Address - Country:US
Practice Address - Phone:812-464-9133
Practice Address - Fax:812-464-0559
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01031400A207RC0000X, 207RI0011X
KY29234207RI0011X, 207RC0000X
IL036-082325207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
138209OtherHEALTHLINK
839574POtherSIHO
000000042522OtherANTHEM
IN100344090Medicaid
10799BOtherCIGNA
KY64753825Medicaid
IN060009029Medicare PIN
IN178910MMedicare PIN
000000042522OtherANTHEM
D95723Medicare UPIN
138209OtherHEALTHLINK
10799BOtherCIGNA
ILP00320975Medicare PIN