Provider Demographics
NPI:1962482950
Name:DONNARD, RICHARD REED (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:REED
Last Name:DONNARD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 TAMARACK RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-2303
Mailing Address - Country:US
Mailing Address - Phone:740-522-7600
Mailing Address - Fax:740-522-6399
Practice Address - Street 1:1930 TAMARACK RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-2303
Practice Address - Country:US
Practice Address - Phone:740-522-7600
Practice Address - Fax:740-522-6399
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34004971207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0825030Medicaid
OH0825030Medicaid
OHD72407Medicare UPIN