Individual
SCOTT C RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7747 W JEFFERSON BLVD, SUITE A, FORT WAYNE, IN 46804
(260) 459-8444
(260) 459-8443
Mailing address
PO BOX 549, WABASH, IN 46992-0549
(260) 569-9550
(260) 569-0760
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
01071002A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201071420
—
IN
Enumeration date
11/18/2005
Last updated
08/15/2018
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