Provider Demographics
NPI:1023103892
Name:RICHARD F TERRY MD INC
Entity type:Organization
Organization Name:RICHARD F TERRY MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:P
Authorized Official - Last Name:TURKALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-242-4700
Mailing Address - Street 1:111 PARK VIEW LN STE 202
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-5406
Mailing Address - Country:US
Mailing Address - Phone:304-242-4700
Mailing Address - Fax:304-242-7012
Practice Address - Street 1:111 PARK VIEW LN STE 202
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-5406
Practice Address - Country:US
Practice Address - Phone:304-242-4700
Practice Address - Fax:304-242-7012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV9894174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0082552000Medicaid
WVA27008Medicare UPIN
WV0082552000Medicaid