Individual
RANDALL R RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3700 WASHINGTON AVE, EVANSVILLE, IN 47714-0541
(317) 872-6287
Mailing address
2001 W 86TH STREET, INDIANAPOLIS, IN 46260
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01044173A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000765918
ANTHEM PROVIDER NUMBER
IN
05
—
200472380
—
IN
Enumeration date
09/09/2005
Last updated
08/02/2023
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