Provider Demographics
NPI:1225279136
Name:MENZEL, RICHARD RYAN (DO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:RYAN
Last Name:MENZEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12368 STRATFORD DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8162
Mailing Address - Country:US
Mailing Address - Phone:515-961-0453
Mailing Address - Fax:515-961-2714
Practice Address - Street 1:12368 STRATFORD DR
Practice Address - Street 2:SUITE 300
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8162
Practice Address - Country:US
Practice Address - Phone:515-961-0453
Practice Address - Fax:515-961-2714
Is Sole Proprietor?:No
Enumeration Date:2009-03-23
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2586032085R0202X
IADO-046922085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology