Provider Demographics
NPI:1043209166
Name:PRICE, RICHARD CHRISTIAN (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:CHRISTIAN
Last Name:PRICE
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 1:2820 E ROCK HAVEN ROAD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HARRISONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64701
Mailing Address - Country:US
Mailing Address - Phone:816-380-7470
Mailing Address - Fax:816-380-3291
Practice Address - Street 1:2820 E ROCK HAVEN ROAD
Practice Address - Street 2:SUITE 210
Practice Address - City:HARRISONVILLE
Practice Address - State:MO
Practice Address - Zip Code:64701
Practice Address - Country:US
Practice Address - Phone:816-380-7470
Practice Address - Fax:816-380-3291
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5B11207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201525003Medicaid
08924029OtherBCBS
7066468Medicare PIN
C51024Medicare UPIN