MEDICARE: DR. RICHARD KEITH DOBYNS D.O.

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
1	207Q00000X	Family Medicine Physician	02001426A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00689415	OTHER	IN	MEDICARE RAIL ROAD

Other Identifiers

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

General Provider Information

NPI Number	:	1245230788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD KEITH DOBYNS D.O.

Provider Business Mailing Address
First Line	:	795 SIM HODGIN PKWY
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-1928
Country	:	US
Telephone Number	:	765-566-5949
Fax Number	:	765-962-6268

Provider Business Practice Location Address
First Line	:	2030 CHESTER BLVD
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-1215
Country	:	US
Telephone Number	:	765-966-3100
Fax Number	:	765-966-3131

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	05/18/2009

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