Healthcare Provider Details

I. General information

NPI: 1245289529
Provider Name (Legal Business Name): RICHARD A. BANKS JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2960 MACK RD STE 110
FAIRFIELD OH
45014-5373
US

IV. Provider business mailing address

764 SACO LOWELL RD
EASLEY SC
29640-3880
US

V. Phone/Fax

Practice location:
  • Phone: 513-296-8090
  • Fax: 513-808-9663
Mailing address:
  • Phone: 864-855-5525
  • Fax: 864-855-5440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number12294
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number12294
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35133415
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: