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NPI Code Detail

MEDICARE: RICHARD PAUL VALUCK JR. M.D.

MEDICARE: RICHARD PAUL VALUCK JR. 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
1207RC0000XCardiovascular Disease PhysicianR2P46MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111066OTHERMOBLUE CROSS/SHIELD PROV.
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366444549
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD PAUL VALUCK JR. M.D.
Provider Business Mailing Address
First Line : 6500 HOSPITAL DR
Second Line :
City : HANNIBAL
State : MO
Zip : 63401-6890
Country : US
Telephone Number : 573-629-3300
Fax Number : 573-629-3314
Provider Business Practice Location Address
First Line : 6500 HOSPITAL DR
Second Line :
City : HANNIBAL
State : MO
Zip : 63401-6890
Country : US
Telephone Number : 573-629-3300
Fax Number : 573-629-3314
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 06/10/2011

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