Individual
RICHARD LYNN NEWCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02635
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13839018
BLUE CROSS BLUE SHIELD
—
01
—
160226
BLUE CROSS BLUE SHIELD
MO
05
—
312171705
—
MO
01
—
410029304
RAILROAD MEDICARE
—
Enumeration date
08/30/2006
Last updated
06/26/2015
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