Individual
COBY T RICHESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10421 E COUNTY ROAD 100 N, INDIANAPOLIS, IN 46234-1243
(317) 272-7013
(317) 272-7007
Mailing address
10421 E COUNTY ROAD 100 N, INDIANAPOLIS, IN 46234-1243
(317) 272-7013
(317) 272-7007
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01053052A
IN
208000000X
Pediatrics Physician
01053052A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000244563
ANTHEM
IN
05
—
200387460
—
IN
Enumeration date
05/10/2006
Last updated
03/29/2021
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