Provider Demographics
NPI:1649700295
Name:AKROMIS, RICHARD (PA-C)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:AKROMIS
Suffix:
Gender:M
Credentials:PA-C
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 268
Mailing Address - Street 2:
Mailing Address - City:OBERLIN
Mailing Address - State:KS
Mailing Address - Zip Code:67749-0268
Mailing Address - Country:US
Mailing Address - Phone:785-475-2208
Mailing Address - Fax:
Practice Address - Street 1:810 W COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:KS
Practice Address - Zip Code:67749-2450
Practice Address - Country:US
Practice Address - Phone:785-475-2208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2120363A00000X
IA087170363A00000X
KS15-01991363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA087170OtherSTATE OF IOWA BOARD OF PHYSICIAN ASSISTANTS
KS15-01991OtherKANSAS STATE BOARD OF HEALING ARTS
NE2120OtherSTATE OF NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES