Basic Information
Provider Information
NPI: 1609282656
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PRICE
FirstName: RICHARD
MiddleName:  
NamePrefix: DR.
NameSuffix: III
Credential: M.D., PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5310 KIETZKE LN STE 104
Address2:  
City: RENO
State: NV
PostalCode: 895112043
CountryCode: US
TelephoneNumber: 7753385897
FaxNumber:  
Practice Location
Address1: 9990 DOUBLE R BLVD STE 200
Address2:  
City: RENO
State: NV
PostalCode: 895214833
CountryCode: US
TelephoneNumber: 7753488800
FaxNumber: 7753488818
Other Information
ProviderEnumerationDate: 07/09/2014
LastUpdateDate: 03/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207T00000X2014016518MON Allopathic & Osteopathic PhysiciansNeurological Surgery 
207T00000X21168NVY Allopathic & Osteopathic PhysiciansNeurological Surgery 

No ID Information.


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