Healthcare Provider Details

I. General information

NPI: 1740228782
Provider Name (Legal Business Name): RICHARD W. SCHAFER, D.O., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 E CHESTNUT ST
HOLLIS OK
73550-2032
US

IV. Provider business mailing address

PO BOX 231
HOLLIS OK
73550-0231
US

V. Phone/Fax

Practice location:
  • Phone: 580-688-3314
  • Fax: 580-688-9530
Mailing address:
  • Phone: 580-688-3314
  • Fax: 580-688-9530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3218
License Number StateOK

VIII. Authorized Official

Name: DR. RICHARD WRIGHT SCHAFER
Title or Position: CEO
Credential: D.O.
Phone: 580-688-3314