MEDICARE: RICHARD A. WOLF 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
1	207RC0000X	Cardiovascular Disease Physician	69334	AZ

General Provider Information

NPI Number	:	1962440552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD A. WOLF M.D.

Provider Business Mailing Address
First Line	:	3003 HIGHWAY 95 STE 102
Second Line	:
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86442-7802
Country	:	US
Telephone Number	:	417-291-0380
Fax Number	:

Provider Business Practice Location Address
First Line	:	3003 HIGHWAY 95 STE 102
Second Line	:
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86442-7802
Country	:	US
Telephone Number	:	417-291-0380
Fax Number	:

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

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	06/24/2025

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