Richard K Niccum, MD - Emergency Medicine in Fort Wayne, IN

Richard K Niccum, MD is a Emergency Medicine physician based in Fort Wayne, Indiana. Richard K Niccum is licensed to practice in Indiana (license number 01037769A) and his current practice location is 2121 Lake Ave, Fort Wayne, Indiana. He can be reached at his office (for appointments etc.) via phone at (260) 426-5431.

NPI number for Richard K Niccum is 1417907122 and his current mailing address is 3460 N State Road 109, Columbia City, Indiana. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1417907122.

Contact Information

Richard K Niccum, MD
2121 Lake Ave,
Fort Wayne, IN 46805-5100
(260) 426-5431
Not Available

Map and Direction




Physician's Profile

Full NameRichard K Niccum
GenderMale
SpecialityEmergency Medicine
Location2121 Lake Ave, Fort Wayne, Indiana
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1417907122
  • Provider Enumeration Date: 05/11/2006
  • Last Update Date: 05/22/2013

Medical Identifiers

Medical identifiers for Richard K Niccum such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1417907122NPI-NPPES
200210570MedicaidIN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 01037769A (Indiana)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Richard K Niccum is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Richard K Niccum, MD
3460 N State Road 109,
Columbia City, IN 46725-8953

Ph: (260) 229-1714
Richard K Niccum, MD
2121 Lake Ave,
Fort Wayne, IN 46805-5100

Ph: (260) 426-5431

Reviews and Comments


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