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General NPI Number Information
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NPI Number | 1033287149
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Entity Type | Individual
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Provider Name | RICHARD MIETHKE MD
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Gender | Male
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2502 25TH ST
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City | COLUMBUS
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State | IN
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Zip | 47201-3728
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Country | US
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Telephone | 812-372-8883
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Fax | 812-372-8964
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Provider Business Mailing Address
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Address Line | 2502 25TH ST
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City | COLUMBUS
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State | IN
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Zip | 47201-3728
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Country | US
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Telephone | 812-372-8883
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Fax | 812-372-8964
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01020385A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number | 01020385A
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License Number State | IN
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