Individual
MR. RICHARD J MAILLOUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
DR. RICHARD MAILLOUX, 198 CARRIAGE DRIVE, BECKLEY, WV 25801-2804
(304) 256-4348
(681) 207-5101
Mailing address
DR. RICHARD MAILLOUX, 198 CARRIAGE DRIVE, BECKLEY, WV 25801-2804
(304) 256-4348
(681) 207-5101
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
18094
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000691895
ANTHEM BCBS
KY
05
—
0088257000
—
WV
01
—
0151526
MEDICAID
OH
01
—
110103523
RAILROAD MEDICARE
—
05
—
64072697
—
KY
Enumeration date
06/06/2006
Last updated
09/18/2019
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