Provider Demographics
NPI:1366449464
Name:ROY, RICHARD A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:ROY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3100 PLAZA PROPERTIES BLVD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-1531
Mailing Address - Country:US
Mailing Address - Phone:614-751-1010
Mailing Address - Fax:614-751-4692
Practice Address - Street 1:3100 PLAZA PROPERTIES BLVD
Practice Address - Street 2:SUITE 320
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-1531
Practice Address - Country:US
Practice Address - Phone:614-751-1010
Practice Address - Fax:614-751-4692
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35060013208800000X
OH35-06-0013-R208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0792049Medicaid
OH0347841OtherRAILROAD MEDICARE
OH0792049Medicaid
OHE70877Medicare UPIN