MEDICARE: DEBRA L RICHARDSON M.D.

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	207VX0201X	Gynecologic Oncology Physician	33286	OK

General Provider Information

NPI Number	:	1992784987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA L RICHARDSON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 845347
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-5347
Country	:	US
Telephone Number	:	214-648-7250
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 NE 10TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-5418
Country	:	US
Telephone Number	:	405-271-7770
Fax Number	:

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	11/09/2021

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