Provider Demographics
NPI:1831168970
Name:BESSETTE, RICHARD ALPHONSE (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ALPHONSE
Last Name:BESSETTE
Suffix:
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 1:1525 VISTA LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-4626
Mailing Address - Country:US
Mailing Address - Phone:775-887-8885
Mailing Address - Fax:775-887-9117
Practice Address - Street 1:1525 VISTA LN
Practice Address - Street 2:SUITE 100
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4626
Practice Address - Country:US
Practice Address - Phone:775-887-8885
Practice Address - Fax:775-887-9117
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6033208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
E48479Medicare UPIN
NVV100358Medicare PIN