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General NPI Number Information
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NPI Number | 1063672400
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Entity Type | Individual
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Provider Name | RICHARD NEIL O'DESKY DO
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Gender | Male
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | 2554 IRA RD
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City | AKRON
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State | OH
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Zip | 44333-1910
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Country | US
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Telephone | 330-666-5832
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Fax |
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Provider Business Mailing Address
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Address Line | 2554 IRA RD
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City | AKRON
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State | OH
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Zip | 44333-1910
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Country | US
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Telephone | 330-666-5832
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Fax |
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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 | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 34-002896
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License Number State | OH
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