Provider Demographics
NPI:1720191182
Name:TAGGART, RICHARD E JR (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:E
Last Name:TAGGART
Suffix:JR
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 1:111 S FRONT ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17101-2010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 S FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101-2010
Practice Address - Country:US
Practice Address - Phone:717-782-3380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023422E207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50010144OtherCAPITAL BC
PA8875OtherGEISINGER
PA000476159OtherHIGHMARK BS
PA145567OtherUNISON
PA0014910930003Medicaid
PA0014910930004Medicaid
PA1518462OtherGATEWAY
PA30024885OtherKEYSTONE MERCY
PA8875OtherGEISINGER
PA145567OtherUNISON
PAB42170Medicare UPIN