Individual
DR. RICHARD O ROTHWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
928 N GLENWOOD BLVD, SUITE 415, TYLER, TX 75702-5055
(903) 535-9041
Mailing address
PO BOX 844273, DALLAS, TX 75284-4273
(903) 535-9041
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
D9644
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032986405
—
TX
01
—
45-2578435-002
TRICARE
TX
01
—
8EX185
BCBS
TX
01
—
P01459210
RAIL ROAD MEDICARE
TX
Enumeration date
07/17/2006
Last updated
06/26/2015
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