Provider Demographics
NPI:1821109737
Name:FLEMING, RICHARD JOSEPH (PT)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:JOSEPH
Last Name:FLEMING
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 APEX DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IL
Mailing Address - Zip Code:62249-1282
Mailing Address - Country:US
Mailing Address - Phone:618-651-0444
Mailing Address - Fax:618-654-5439
Practice Address - Street 1:144 LINCOLN PLACE CT
Practice Address - Street 2:SUITE 1
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62201
Practice Address - Country:US
Practice Address - Phone:618-233-5163
Practice Address - Fax:618-233-5164
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO106966225100000X
VA2305212691225100000X
IL07015509225100000X
TX1319774225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1319774OtherTEXAS BOARD OF PHYSICAL THERAPY EXAMINERS
VA2305212691OtherVIRGINIA DEPARTMENT OF HEALTH PROFESSIONS