Healthcare Provider Details

I. General information

NPI: 1497751382
Provider Name (Legal Business Name): RICHARD WARD FURAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 08/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1343 N FOUNTAIN BLVD 2ND FLOOR IMAGING CENTER
SPRINGFIELD OH
45504-1422
US

IV. Provider business mailing address

1343 N FOUNTAIN BLVD 2ND FLOOR IMAGING CENTER
SPRINGFIELD OH
45504-1422
US

V. Phone/Fax

Practice location:
  • Phone: 937-323-2690
  • Fax: 937-323-1009
Mailing address:
  • Phone: 937-323-2690
  • Fax: 937-323-1009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35055025F
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: