Healthcare Provider Details

I. General information

NPI: 1518066018
Provider Name (Legal Business Name): JOHN RICHARD URBACH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 EAST BROAD STREET BOX 980710
RICHMOND VA
23298-0710
US

IV. Provider business mailing address

2722 HILLCREST RD
RICHMOND VA
23225-3636
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-9158
  • Fax:
Mailing address:
  • Phone: 804-231-1225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: