Healthcare Provider Details

I. General information

NPI: 1235176686
Provider Name (Legal Business Name): RICHARD A FIKES DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 MEMORIAL DR
BELLEVILLE IL
62226-5360
US

IV. Provider business mailing address

20 TIMBERKNOLL LOOP
POWELL OH
43065-6657
US

V. Phone/Fax

Practice location:
  • Phone: 618-257-6220
  • Fax: 618-257-6679
Mailing address:
  • Phone: 614-440-7424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036170831
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34008527
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number34-008527
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: