Provider Demographics
NPI:1669900916
Name:WILLNER, RICHARD BARKAN (DPM)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BARKAN
Last Name:WILLNER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4136 MEDOC DR
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-1923
Mailing Address - Country:US
Mailing Address - Phone:504-621-1670
Mailing Address - Fax:504-305-3998
Practice Address - Street 1:3140 GARDEN OAKS DR STE 101
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-6745
Practice Address - Country:US
Practice Address - Phone:504-621-1670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD048R213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1539708Medicaid