Provider Demographics
NPI:1184722381
Name:INGLIS, RICHARD BRIAN (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BRIAN
Last Name:INGLIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 SIXTH ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-4603
Mailing Address - Country:US
Mailing Address - Phone:203-325-3055
Mailing Address - Fax:203-325-3551
Practice Address - Street 1:35 SIXTH ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-4603
Practice Address - Country:US
Practice Address - Phone:203-325-3055
Practice Address - Fax:203-325-3551
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT185111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT566838OtherAETNA
CT786738OtherCONNECTICARE
CT004058392-00Medicaid
CT050000185CT01OtherBLUE CROSS
CTZS781OtherOXFORD
CT050000185CT01OtherBLUE CROSS