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Individual
RICHARD W BACON
Active
Individual
RICHARD W BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD017512E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007658180001
—
PA
05
—
0007658180004
—
PA
01
—
01485901
CAPITAL BLUE CROSS
PA
01
—
064029
HIGHMARK BLUE SHIELD
PA
01
—
50041793
CAPITAL BLUE CROSS
PA
01
—
50043833
CAPITAL BLUE CROSS
PA
01
—
50046244
CAPITAL BLUE CROSS
PA
01
—
50060205
CAPITAL BLUE CROSS
PA
01
—
50061963
CAPITAL BLUE CROSS
PA
01
—
50068264
CAPITAL BLUE CROSS
PA
01
—
51411 S1QI
GEISINGER HEALTH PLAN
PA
01
—
C28692
HEALTH ASSURANCE
PA
01
—
P002645
GATEWAY HEALTH PLAN
PA
Enumeration date
01/03/2006
Last updated
09/06/2007
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