Provider Demographics
NPI:1902899735
Name:RICHARD, HENRI CLAUDE (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRI CLAUDE
Middle Name:
Last Name:RICHARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 W LINCOLN TRAIL BLVD
Mailing Address - Street 2:
Mailing Address - City:RADCLIFF
Mailing Address - State:KY
Mailing Address - Zip Code:40160-2602
Mailing Address - Country:US
Mailing Address - Phone:270-351-4342
Mailing Address - Fax:270-351-5499
Practice Address - Street 1:650 W LINCOLN TRAIL BLVD
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-2602
Practice Address - Country:US
Practice Address - Phone:270-351-4342
Practice Address - Fax:270-351-5499
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY192142085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64192149Medicaid
KY64192149Medicaid
D08042Medicare UPIN