Provider Demographics
NPI:1497751382
Name:FURAY, RICHARD WARD (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WARD
Last Name:FURAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1343 N FOUNTAIN BLVD
Mailing Address - Street 2:2ND FLOOR IMAGING CENTER
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-1422
Mailing Address - Country:US
Mailing Address - Phone:937-323-2690
Mailing Address - Fax:937-323-1009
Practice Address - Street 1:1343 N FOUNTAIN BLVD
Practice Address - Street 2:2ND FLOOR IMAGING CENTER
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1422
Practice Address - Country:US
Practice Address - Phone:937-323-2690
Practice Address - Fax:937-323-1009
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-24
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35055025F208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH010019874OtherRAIL ROAD MEDICARE
OH1720126OtherUNITED HEALTH CARE
OH311202862026OtherCARESOURCE
OH000000014682OtherANTHEM AND ONE NATION
OH0655287Medicaid
OH311202862026OtherCARESOURCE
OHFU0599621Medicare PIN