Provider Demographics
NPI:1952338634
Name:NOLAND, RICHARD
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:NOLAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 RED LEAF CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1759
Mailing Address - Country:US
Mailing Address - Phone:859-268-2525
Mailing Address - Fax:859-268-2255
Practice Address - Street 1:2909 RICHMOND RD
Practice Address - Street 2:SUITE 30
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1764
Practice Address - Country:US
Practice Address - Phone:859-268-2525
Practice Address - Fax:859-268-2255
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY45903176Medicaid
KY90950346Medicaid
KY0771740002Medicare ID - Type UnspecifiedMEDICARE