Provider Demographics
NPI:1255431813
Name:HON, RICHARD LEE JR (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:LEE
Last Name:HON
Suffix:JR
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 1:1500 N RITTER AVE
Mailing Address - Street 2:BUILDING 4 - FIRST FLOOR
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-3027
Mailing Address - Country:US
Mailing Address - Phone:317-355-6347
Mailing Address - Fax:317-351-5477
Practice Address - Street 1:1709 N POST RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-1924
Practice Address - Country:US
Practice Address - Phone:317-355-6347
Practice Address - Fax:317-351-5477
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01063838A2083X0100X
IL2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G08760Medicare UPIN
ILK08533Medicare ID - Type UnspecifiedINDIVIDUAL #
IL833120Medicare ID - Type UnspecifiedGROUP #