Individual
RICHARD ANTHONY BOADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3118 E 10TH ST STE B, JEFFERSONVILLE, IN 47130-5904
(812) 285-4585
(812) 284-2798
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01050219A
IN
208000000X
Pediatrics Physician
32419
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200209820
—
IN
05
—
64324197
—
KY
01
—
IN4465001
MEDICARE
IN
Enumeration date
10/25/2006
Last updated
09/21/2022
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