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General NPI Number Information
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NPI Number | 1194810150
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Entity Type | Individual
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Provider Name | RICHARD JAMES MISISCHIA SR. D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 3600 KOLBE RD STE 103
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City | LORAIN
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State | OH
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Zip | 44053-1652
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Country | US
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Telephone | 440-222-4188
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Fax | 440-222-4189
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Provider Business Mailing Address
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Address Line | PO BOX 2379
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City | ASHLAND
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State | KY
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Zip | 41105-2379
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Country | US
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Telephone |
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | DO.477
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 05068
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License Number State | KY
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