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Individual

RICHARD N MEDLEY III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1919 STATE ST, NEW ALBANY, IN 47150-4929
(812) 282-3899
(812) 282-4173
Mailing address
101 HOSPITAL BLVD, JEFFERSONVILLE, IN 47130-3748
(812) 282-3899
(812) 282-4173

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01043575A
IN
208800000X
Urology Physician
29716
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200122970
IN
01
340013659
RR MCR
KY
05
64297161
KY
01
P00229858
RR MCR
IN
Enumeration date
10/04/2005
Last updated
01/03/2020
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