Provider Demographics
NPI:1063672400
Name:O'DESKY, RICHARD NEIL (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:NEIL
Last Name:O'DESKY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2554 IRA RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-1910
Mailing Address - Country:US
Mailing Address - Phone:330-666-5832
Mailing Address - Fax:
Practice Address - Street 1:2554 IRA RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-1910
Practice Address - Country:US
Practice Address - Phone:330-666-5832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-0028962083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine