MEDICARE: DR. JOHN RICHARD HLADIK D.P.M.

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	213ES0103X	Foot & Ankle Surgery Podiatrist	00700873	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	480030668	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
3	352059940	OTHER	IN	WORKERS COMPENSATION
4	000000093267	OTHER	IN	BLUE SHIELD

General Provider Information

NPI Number	:	1528063427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN RICHARD HLADIK D.P.M.

Provider Business Mailing Address
First Line	:	411 PLAZA DR STE H
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-2918
Country	:	US
Telephone Number	:	812-372-6274
Fax Number	:	812-372-9357

Provider Business Practice Location Address
First Line	:	411 PLAZA DR STE H
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201
Country	:	US
Telephone Number	:	812-372-6274
Fax Number	:	812-372-9357

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	12/04/2019

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Directions to “ DR. JOHN RICHARD HLADIK D.P.M.” Practice Location

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