MEDICARE: DR. RICK W GEBHART 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	34005782	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	080191701	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23334	OTHER	OH	NATIONWIDE HEALTH PLAN
2	D0578203	OTHER	OH	HUMANA/CHOICECARE
3	0122721	OTHER	OH	UNITED HEALTHCARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	2192769	OTHER	OH	AETNA
7	302622980900	OTHER	OH	OHIO BWC
8	000000227856	OTHER	OH	ANTHEM
9	147240004	OTHER	OH	CARESOURCE
10	34005782	OTHER	OH	MEDICAL LICENSE

General Provider Information

NPI Number	:	1306849823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICK W GEBHART D.O.

Provider Business Mailing Address
First Line	:	1 PRESTIGE PL STE 550
Second Line	:
City	:	MIAMISBURG
State	:	OH
Zip	:	45342-6115
Country	:	US
Telephone Number	:	937-619-0050
Fax Number	:	937-619-0069

Provider Business Practice Location Address
First Line	:	505 CORPORATE CENTER DR
Second Line	:
City	:	VANDALIA
State	:	OH
Zip	:	45377-1167
Country	:	US
Telephone Number	:	937-619-0050
Fax Number	:	937-619-0069

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

Provider Enumeration Date	:	05/30/2005
Last Update Date	:	01/24/2019

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