Provider Demographics
NPI:1154324259
Name:JAMES, RICHARD (DPM)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:JAMES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 E 6TH AVE
Mailing Address - Street 2:STE 2A
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-3145
Mailing Address - Country:US
Mailing Address - Phone:620-221-4443
Mailing Address - Fax:
Practice Address - Street 1:1230 E 6TH AVE
Practice Address - Street 2:STE 2A
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-3145
Practice Address - Country:US
Practice Address - Phone:620-221-4443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1200222213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH621591OtherMCD HMO
OH100226980CMedicaid
OHP00177373OtherRAILROAD MEDICARE
OH621591OtherMCD HMO
OH100226980CMedicaid