Provider Demographics
NPI:1619051521
Name:RICHARD T. SENN, MD, INC.
Entity Type:Organization
Organization Name:RICHARD T. SENN, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:T
Authorized Official - Last Name:SENN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-453-4654
Mailing Address - Street 1:113 W SOUTHWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-3653
Mailing Address - Country:US
Mailing Address - Phone:765-453-4654
Mailing Address - Fax:765-455-2266
Practice Address - Street 1:113 W SOUTHWAY BLVD
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3653
Practice Address - Country:US
Practice Address - Phone:765-453-4654
Practice Address - Fax:765-455-2266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN50001606A2088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric UrologyGroup - Single Specialty