MEDICARE: RICHARD J HELTON

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
1	207Q00000X	Family Medicine Physician	2096	OK
2	261QR1300X	Rural Health Clinic/Center	2096	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972545820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD J HELTON

Provider Business Mailing Address
First Line	:	PO BOX 345
Second Line	:
City	:	COALGATE
State	:	OK
Zip	:	74538-0345
Country	:	US
Telephone Number	:	580-927-2334
Fax Number	:	580-927-9941

Provider Business Practice Location Address
First Line	:	108 W OHIO
Second Line	:
City	:	COALGATE
State	:	OK
Zip	:	74538-2827
Country	:	US
Telephone Number	:	580-927-2334
Fax Number	:	580-927-9941

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	06/18/2015

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Directions to “ RICHARD J HELTON ” Practice Location

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