Provider Demographics
NPI:1457343998
Name:REUL, RICHARD T (DC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:T
Last Name:REUL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3772 TAYLORSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-1343
Mailing Address - Country:US
Mailing Address - Phone:502-458-2559
Mailing Address - Fax:
Practice Address - Street 1:3772 TAYLORSVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1343
Practice Address - Country:US
Practice Address - Phone:502-458-2559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4208111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000507751OtherANTHEM BC/BS
KY3787352-002OtherCIGNA
KY4456909OtherAETNA
KY85002087Medicaid
KY6112580629A11OtherANTHEM SENIOR ADVANTAGE
KY116212OtherPASSPORT
KY00324001Medicare PIN
KY3787352-002OtherCIGNA