Provider Demographics
NPI:1952347163
Name:BAKIR, RICHARD M (DC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:M
Last Name:BAKIR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9455 W RUSSELL RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5552
Mailing Address - Country:US
Mailing Address - Phone:702-220-7646
Mailing Address - Fax:702-944-4379
Practice Address - Street 1:9455 W RUSSELL RD
Practice Address - Street 2:SUITE C
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5552
Practice Address - Country:US
Practice Address - Phone:702-220-7646
Practice Address - Fax:702-944-4379
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-944111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U94072Medicare UPIN