Provider Demographics
NPI:1396734125
Name:FELKER, RICHARD (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:FELKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5655 HUDSON DR STE 210
Mailing Address - Street 2:ARIS RADIOLOGY
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4455
Mailing Address - Country:US
Mailing Address - Phone:330-655-1869
Mailing Address - Fax:330-655-7828
Practice Address - Street 1:5655 HUDSON DR STE 210
Practice Address - Street 2:ARIS RADIOLOGY
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4455
Practice Address - Country:US
Practice Address - Phone:330-655-1869
Practice Address - Fax:330-655-7828
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA054879174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE44562Medicare UPIN