Provider Demographics
NPI:1437240827
Name:RICHARD, PATRICK N (OD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:N
Last Name:RICHARD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 S MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46225-1306
Mailing Address - Country:US
Mailing Address - Phone:317-636-4448
Mailing Address - Fax:317-636-4476
Practice Address - Street 1:932 S MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46225-1306
Practice Address - Country:US
Practice Address - Phone:317-636-4448
Practice Address - Fax:317-636-4476
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18001585A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00217424OtherPALMETTO GBA RR MEDICARE
IN000000364683OtherANTHEM
IN225170BMedicare PIN
IN000000364683OtherANTHEM
IN5423480001Medicare NSC