Individual
RICHARD ANTHONY ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
202 E BRIGGS AVE, FAIRFIELD, IA 52556-2925
(641) 472-9731
(641) 472-9589
Mailing address
PO BOX 1687, FAIRFIELD, IA 52556-0029
(641) 472-9371
(641) 472-9589
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
688
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0151696
—
IA
01
—
58773
BC / BS
IA
01
—
8970
MIDLAND'S CHOICE
—
Enumeration date
10/27/2005
Last updated
10/02/2008
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