Doctor Name: | RONALD RICHARDSON |
NPI Number: | 1083630123 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 2-5-1175 |
Business Practice Address: | 918 W Broadway St Suite B Collinsville, OK - 740212431 |
Business Phone Number: | 9183716997 |
Business Fax Number: | 9183716997 |
Mailing Address: | 918 W Broadway St, Suite B COLLINSVILLE |
State: | OK |
Postal Code: | 740212431 |
Phone Number: | 9183716997 |
Fax Number: | 9183716997 |
NPI Enumeration Date: | 07/14/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BX2000X |
License Number: | 2-5-1175 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Oxygen Equipment & Supplies |
Taxonomy Definition: |