Individual
DR. RICHARD ALLEN CIRELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
955 BLACK DR, PRESCOTT, AZ 86305-1403
(928) 445-7546
(928) 445-7598
Mailing address
955 BLACK DR, PRESCOTT, AZ 86305-1403
(928) 445-7546
(928) 445-7598
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
27370
AZ
207ND0101X
MOHS-Micrographic Surgery Physician
27370
AZ
207NP0225X
Pediatric Dermatology Physician
27370
AZ
207NS0135X
Procedural Dermatology Physician
27370
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
465155
—
AZ
Enumeration date
07/05/2005
Last updated
10/12/2018
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