Provider Demographics
NPI:1487637377
Name:HILKER, RICHARD M (DPM)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:M
Last Name:HILKER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10323 DAWSONS CREEK
Mailing Address - Street 2:BLDG 10 C
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-1910
Mailing Address - Country:US
Mailing Address - Phone:260-490-3668
Mailing Address - Fax:260-490-7574
Practice Address - Street 1:10323 DAWSONS CREEK
Practice Address - Street 2:BLDG 10 C
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1910
Practice Address - Country:US
Practice Address - Phone:260-490-3668
Practice Address - Fax:260-490-7574
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-23
Last Update Date:2008-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000508213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100223400AMedicaid
IN480029648Medicare PIN
IN224790AMedicare PIN
IN100223400AMedicaid
IN4135620001Medicare NSC
IN4135620002Medicare NSC
INCH5527Medicare PIN
IN224790Medicare PIN