Individual
DR. RICHARD JAY IKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1125 MADISON ST, JEFFERSON CITY, MO 65101-5227
(573) 632-5525
(573) 632-5811
Mailing address
1125 MADISON ST, JEFFERSON CITY, MO 65101-5227
(573) 632-5525
(573) 632-5811
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
M2657
TX
208000000X
Pediatrics Physician
Primary
R3B55
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962613430
—
MO
Enumeration date
05/25/2007
Last updated
02/10/2016
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