Provider Demographics
NPI:1952430647
Name:MEYER, RICHARD BERNARD (RICHARD MEYER, MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BERNARD
Last Name:MEYER
Suffix:
Gender:M
Credentials:RICHARD MEYER, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3785 N CAMINO DE OESTE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-9772
Mailing Address - Country:US
Mailing Address - Phone:520-743-8058
Mailing Address - Fax:520-743-8059
Practice Address - Street 1:3785 N CAMINO DE OESTE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-9772
Practice Address - Country:US
Practice Address - Phone:520-743-8058
Practice Address - Fax:520-743-8059
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ327702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1187749Medicaid
CT1187749Medicaid