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NPI Code Detail

MEDICARE: DR. RICHARD VINCENT HAUSROD MD

MEDICARE: DR. RICHARD VINCENT HAUSROD 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
1207P00000XEmergency Medicine PhysicianMD427532PA
2207P00000XEmergency Medicine Physician35.087318OH

General Provider Information

NPI Number : 1962493304
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD VINCENT HAUSROD MD
Provider Business Mailing Address
First Line : 498 BAY HILL DRIVE
Second Line :
City : AVON LAKE
State : OH
Zip : 44012
Country : US
Telephone Number : 440-930-5040
Fax Number :
Provider Business Practice Location Address
First Line : 630 E RIVER ST
Second Line :
City : ELYRIA
State : OH
Zip : 44035-5902
Country : US
Telephone Number : 440-329-7539
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2005
Last Update Date : 07/08/2007

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Directions to “ DR. RICHARD VINCENT HAUSROD MD” Practice Location

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