Provider Demographics
NPI:1275552929
Name:HALBISCH, RICHARD JOSEPH JR (RPSGT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:JOSEPH
Last Name:HALBISCH
Suffix:JR
Gender:M
Credentials:RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16601 N 40TH ST
Mailing Address - Street 2:115
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-3345
Mailing Address - Country:US
Mailing Address - Phone:602-682-7630
Mailing Address - Fax:
Practice Address - Street 1:16601 N 40TH ST
Practice Address - Street 2:115
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-3345
Practice Address - Country:US
Practice Address - Phone:602-682-7630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL883246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other