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NPI Code Detail

MEDICARE: RICHARD ALLEN FANKHAUSER M.D.

MEDICARE: RICHARD ALLEN FANKHAUSER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician0980404OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20900871OTHEROHDMERC

General Provider Information

NPI Number : 1023091113
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD ALLEN FANKHAUSER M.D.
Provider Business Mailing Address
First Line : 815 W BROAD ST
Second Line : SUITE 300
City : COLUMBUS
State : OH
Zip : 43222-1548
Country : US
Telephone Number : 614-228-4262
Fax Number : 614-228-6582
Provider Business Practice Location Address
First Line : 815 W BROAD ST
Second Line : SUITE 300
City : COLUMBUS
State : OH
Zip : 43222-1548
Country : US
Telephone Number : 614-228-4262
Fax Number : 614-228-6582
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 11/12/2009

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