MEDICARE: RICHARD W. RIECK MD

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	2085R0202X	Diagnostic Radiology Physician	296953	NY
2	2085R0202X	Diagnostic Radiology Physician	MD26936	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00341056	OTHER		RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1497741714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD W. RIECK MD

Provider Business Mailing Address
First Line	:	210 25TH AVE N
Second Line	:	SUITE 602
City	:	NASHVILLE
State	:	TN
Zip	:	37203-1606
Country	:	US
Telephone Number	:	615-312-0600
Fax Number	:	615-320-3259

Provider Business Practice Location Address
First Line	:	210 25TH AVE N
Second Line	:	STE 602
City	:	NASHVILLE
State	:	TN
Zip	:	37203-1606
Country	:	US
Telephone Number	:	615-312-0600
Fax Number	:	615-320-3259

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	03/01/2024

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