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General NPI Number Information
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NPI Number | 1619051521
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Entity Type | Organization
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Legal Business Name | RICHARD T. SENN, MD, INC.
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 113 W SOUTHWAY BLVD
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City | KOKOMO
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State | IN
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Zip | 46902-3653
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Country | US
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Telephone | 765-453-4654
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Fax | 765-455-2266
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Provider Business Mailing Address
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Address Line | 113 W SOUTHWAY BLVD
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City | KOKOMO
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State | IN
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Zip | 46902-3653
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Country | US
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Telephone | 765-453-4654
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Fax | 765-455-2266
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD T. SENN
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Credential | MD
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Telephone | 765-453-4654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2088P0231X
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Taxonomy Name | Pediatric Urology Physician
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License Number | 50001606A
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License Number State | IN
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