Healthcare Provider Details

I. General information

NPI: 1457599607
Provider Name (Legal Business Name): RICHARD CYRUS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 03/17/2020
Certification Date: 03/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5741 CARMICHAEL PKWY
MONTGOMERY AL
36117-2359
US

IV. Provider business mailing address

5741 CARMICHAEL PKWY
MONTGOMERY AL
36117-2359
US

V. Phone/Fax

Practice location:
  • Phone: 334-281-8008
  • Fax: 334-558-0357
Mailing address:
  • Phone: 334-281-8008
  • Fax: 334-558-0357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD.6126
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: