Individual
DR. CHARLES W RICCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
112 E MCMURTRY AVE, HARTFORD, KY 42347-1634
(270) 298-7225
(270) 298-4084
Mailing address
112 E MCMURTRY AVE, HARTFORD, KY 42347-1634
(270) 298-7225
(270) 298-4084
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
29185
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000050530
BLUE CROSS AND BLUE SHIEL
KY
05
—
1062177
—
KY
01
—
110102005
RAILROAD MEDICARE
KY
05
—
64291859
—
KY
05
—
65923534
—
KY
Enumeration date
08/15/2005
Last updated
05/15/2008
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