Provider Demographics
NPI:1942244090
Name:DAILY, RICHARD E (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:E
Last Name:DAILY
Suffix:
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 1:16 RIMROCK RD
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72802-8878
Mailing Address - Country:US
Mailing Address - Phone:479-747-3582
Mailing Address - Fax:866-716-7912
Practice Address - Street 1:16 RIMROCK RD
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72802-8878
Practice Address - Country:US
Practice Address - Phone:479-747-3582
Practice Address - Fax:866-716-7912
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6D60207P00000X
ARC-5537207P00000X
OK15999207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208887414Medicaid
126814OtherBCBS
250766OtherHEALTHLINK
AR101910001Medicaid
P00031484OtherRAILROAD MEDICARE
AR101910001Medicaid