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General NPI Number Information
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NPI Number | 1841326568
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Entity Type | Organization
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Legal Business Name | W RICHARD LOERKE
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6966 S UTICA AVE SUITE 225
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City | TULSA
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State | OK
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Zip | 74136-3903
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Country | US
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Telephone | 918-492-6333
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Fax |
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Provider Business Mailing Address
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Address Line | 6966 S UTICA AVE SUITE 225
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City | TULSA
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State | OK
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Zip | 74136-3903
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Country | US
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Telephone | 918-493-9405
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. W RICHARD LOERKE
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Credential | D.O.
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Telephone | 918-749-3323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1202
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License Number State | OK
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