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General NPI Number Information
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NPI Number | 1932106853
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Entity Type | Individual
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Provider Name | RICHARD AUGUSTINE CARDONE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 5300 HWY 95 STE. C
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City | BULLHEAD CITY
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State | AZ
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Zip | 86426-9251
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Country | US
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Telephone | 928-768-4100
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Fax | 928-768-6522
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Provider Business Mailing Address
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Address Line | PO BOX 9687
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City | BULLHEAD CITY
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State | AZ
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Zip | 86427-9687
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Country | US
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Telephone | 928-768-4100
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Fax | 928-768-6522
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 26223
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | G84346
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | MD050553L
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License Number State | PA
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