Provider Demographics
NPI:1013905918
Name:RIETHER, ROBERT J (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:RIETHER
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:PO BOX 2568
Mailing Address - Street 2:
Mailing Address - City:DEMING
Mailing Address - State:NM
Mailing Address - Zip Code:88031-2568
Mailing Address - Country:US
Mailing Address - Phone:775-750-9597
Mailing Address - Fax:
Practice Address - Street 1:2420 FAIRWAY DR SE
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-7349
Practice Address - Country:US
Practice Address - Phone:575-546-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2014-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-1196-022085R0202X
OK45962085R0202X
CA20A93032085R0202X
MO322902085R0202X
AZ37672085R0202X
ORDO262072085R0202X
FLOS94162085R0202X
OH340020652085R0202X
NV12412085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology