Provider Demographics
NPI:1477558872
Name:ROLFES, RICHARD JAMES
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JAMES
Last Name:ROLFES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1184 BEVERLY HILL DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-4324
Mailing Address - Country:US
Mailing Address - Phone:513-533-1554
Mailing Address - Fax:
Practice Address - Street 1:5400 KENNEDY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45213-2664
Practice Address - Country:US
Practice Address - Phone:513-281-3400
Practice Address - Fax:513-527-2275
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0591172085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0848944Medicaid
OH0848944Medicaid
OHRO0878475Medicare ID - Type Unspecified