Provider Demographics
NPI:1639319981
Name:BUDNEY, RICHARD A JR (PT)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:BUDNEY
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-3359
Mailing Address - Country:US
Mailing Address - Phone:304-919-0859
Mailing Address - Fax:
Practice Address - Street 1:3468 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-3149
Practice Address - Country:US
Practice Address - Phone:304-919-0859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-26
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT002736208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025382770001Medicaid
PA2556713OtherHIGHMARK BC/BS
PADAPT002323OtherDIRECT ACCESS STATE LICENSE
PAPT020204OtherSTATE LICENSE
PA1025382770001Medicaid