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Individual
MR. RICHARD WILLIAM ROCKWELL
Active
Individual
MR. RICHARD WILLIAM ROCKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
008090-1
NY
363A00000X
Physician Assistant
Primary
MA003059L
PA
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970019007
RR MEDICARE PIN
PA
01
—
CC9269
RR MEDICARE GROUP
PA
01
—
GU039807
PA MEDICARE GROUP
PA
Enumeration date
02/17/2006
Last updated
03/05/2021
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