Provider Demographics
NPI:1447241013
Name:RICHARD PRESTON MD PC
Entity Type:Organization
Organization Name:RICHARD PRESTON MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:PRESTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:515-283-1221
Mailing Address - Street 1:1221 CENTER ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1014
Mailing Address - Country:US
Mailing Address - Phone:515-283-1221
Mailing Address - Fax:515-283-2017
Practice Address - Street 1:1221 CENTER ST
Practice Address - Street 2:SUITE 8
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1014
Practice Address - Country:US
Practice Address - Phone:515-283-1221
Practice Address - Fax:515-283-2017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
03031OtherWELLMARK
IA0070581Medicaid
IA0070581Medicaid