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Individual

RICHARD W REICHERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1615 SW MAIN BLVD, LAKE CITY, FL 32025-1108
(386) 755-2785
(386) 755-1128
Mailing address
PO BOX 489, LAKE CITY, FL 32056-0489
(386) 755-2785
(386) 755-1128

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME0055182
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001933700
FL
05
061547100
FL
05
061547102
FL
01
1180560001
MEDICARE/DMERC
01
180015387
RAILROAD MEDICARE
01
297390
AVMED
FL
01
4099614
AETNA
FL
Enumeration date
07/01/2006
Last updated
03/21/2011
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