Provider Demographics
NPI:1568422954
Name:HAPPEL, RICHARD DOUGLAS (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DOUGLAS
Last Name:HAPPEL
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 HOLSTON RD
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-4109
Mailing Address - Country:US
Mailing Address - Phone:276-228-4860
Mailing Address - Fax:276-228-4879
Practice Address - Street 1:1150 HOLSTON RD
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-4109
Practice Address - Country:US
Practice Address - Phone:276-228-4860
Practice Address - Fax:276-228-4879
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101038312207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006002501Medicaid