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Individual

RICHARD ALLEN FANKHAUSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
815 W BROAD ST, SUITE 300, COLUMBUS, OH 43222-1548
(614) 228-4262
(614) 228-6582
Mailing address
815 W BROAD ST, SUITE 300, COLUMBUS, OH 43222-1548
(614) 228-4262
(614) 228-6582

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0980404
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0485863
OH
01
0900871
DMERC
OH
Enumeration date
11/22/2005
Last updated
11/12/2009
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