Provider Demographics
NPI:1790125805
Name:WEBB, RICHARD TARVER (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:TARVER
Last Name:WEBB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1851 N MCKENZIE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-4703
Mailing Address - Country:US
Mailing Address - Phone:251-677-6821
Mailing Address - Fax:251-677-6813
Practice Address - Street 1:1851 N MCKENZIE ST STE 101
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-4703
Practice Address - Country:US
Practice Address - Phone:251-424-1232
Practice Address - Fax:251-424-1954
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.43394207L00000X, 208VP0014X
MST-2730207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL279191Medicaid
ALA14602AOtherMEDICARE