Basic Information
Provider Information
NPI: 1760649271
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARGEN
FirstName: RICHARD
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3595 US HIGHWAY 50
Address2:  
City: SILVER SPRINGS
State: NV
PostalCode: 894299303
CountryCode: US
TelephoneNumber: 7755772117
FaxNumber: 7755772769
Practice Location
Address1: 3595 US HIGHWAY 50
Address2:  
City: SILVER SPRINGS
State: NV
PostalCode: 894299303
CountryCode: US
TelephoneNumber: 7755772117
FaxNumber: 7755772769
Other Information
ProviderEnumerationDate: 05/21/2008
LastUpdateDate: 05/21/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X3877NVY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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