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NPI Code Detail

MEDICARE: MR. RICHARD EUGENE BOECKMANN P.D.

MEDICARE: MR. RICHARD EUGENE BOECKMANN P.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
1183500000XPharmacist6609AR

General Provider Information

NPI Number : 1184625402
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RICHARD EUGENE BOECKMANN P.D.
Provider Business Mailing Address
First Line : 411 FALLS BLVD S
Second Line :
City : WYNNE
State : AR
Zip : 72396-3501
Country : US
Telephone Number : 870-238-8511
Fax Number : 870-238-2135
Provider Business Practice Location Address
First Line : 411 FALLS BLVD S
Second Line :
City : WYNNE
State : AR
Zip : 72396-3501
Country : US
Telephone Number : 870-238-8511
Fax Number : 870-238-2135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 07/08/2007

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Directions to “ MR. RICHARD EUGENE BOECKMANN P.D.” Practice Location

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