Individual
DR. RICHARD CARL REBUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
805 N MILDRED ST, STE 3, RANSON, WV 25438-1533
(304) 725-2020
(304) 725-2027
Mailing address
805 N MILDRED ST, STE 3, RANSON, WV 25438-1533
(304) 725-2020
(304) 725-2027
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0D971
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00172178
MSBCBS
WV
05
—
9200015000
—
WV
01
—
VA0404
EYE MED
WV
Enumeration date
09/28/2006
Last updated
09/30/2011
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