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NPI Code Detail

MEDICARE: RILEY S SUITER

MEDICARE: RILEY S SUITER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care CoordinatorOK

General Provider Information

NPI Number : 1548194798
Entity Type Code : Individual
Provider Name (Legal Business Name) : RILEY S SUITER
Provider Business Mailing Address
First Line : 180 N DAVIS AVE APT 1
Second Line :
City : CLAREMORE
State : OK
Zip : 74017-3593
Country : US
Telephone Number : 405-642-1635
Fax Number :
Provider Business Practice Location Address
First Line : 2325 S HARVARD AVE
Second Line :
City : TULSA
State : OK
Zip : 74114-3301
Country : US
Telephone Number : 405-642-1635
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2026
Last Update Date : 06/11/2026

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Directions to “ RILEY S SUITER ” Practice Location

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