Provider Demographics
NPI:1871579532
Name:LOUVAR, RICHARD DARRELL (DO)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DARRELL
Last Name:LOUVAR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1515 42ND ST NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-3061
Mailing Address - Country:US
Mailing Address - Phone:319-395-7878
Mailing Address - Fax:319-395-7898
Practice Address - Street 1:1515 42ND ST NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-3061
Practice Address - Country:US
Practice Address - Phone:319-395-7878
Practice Address - Fax:319-395-7898
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01483207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
5336687OtherAETNA
011918081OtherRAILROAD MEDICARE
179301OtherJOHN DEERE HEALTH CARE
0000OtherCHAMPUS
IA0059469Medicaid
IA49757OtherBLUE CROSS BLUE SHIELD IA
0000OtherCHAMPUS
IA49757OtherBLUE CROSS BLUE SHIELD IA
A00808Medicare UPIN