Healthcare Provider Details

I. General information

NPI: 1487698031
Provider Name (Legal Business Name): RICHARD WEBER SEIFERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 04/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 S UTICA AVE SUITE 909
TULSA OK
74104-4005
US

IV. Provider business mailing address

1145 SOUTH UTICA SUITE 909
TULSA OK
74104-4005
US

V. Phone/Fax

Practice location:
  • Phone: 918-584-0123
  • Fax: 918-583-5269
Mailing address:
  • Phone: 918-584-0123
  • Fax: 918-573-5269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number11516
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number11516
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: