Individual
DR. RICHARD LEE THATCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3611 S REED RD, SUITE 104, KOKOMO, IN 46902-3828
(765) 453-5892
(765) 453-8262
Mailing address
3611 S REED RD, SUITE 104, KOKOMO, IN 46902-3828
(765) 453-5892
(765) 453-8262
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
07000359
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000084316
ANTHEM BCBS
IN
01
—
0351930001
DMERC
IN
05
—
100234130
—
IN
01
—
406480189
MEDICARE RAILROAD
IN
Enumeration date
10/03/2006
Last updated
11/30/2011
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