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General NPI Number Information
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NPI Number | 1942598628
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Entity Type | Organization
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Legal Business Name | ENID UROLOGY ASSOCIATES, INC
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Dates
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Enumeration Date | 07/15/2011
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 609 VIRGINIA AVE
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City | PONCA CITY
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State | OK
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Zip | 74601-2911
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Country | US
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Telephone | 580-233-3230
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Fax | 580-233-0698
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Provider Business Mailing Address
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Address Line | 615 E OKLAHOMA AVE STE 202
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City | ENID
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State | OK
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Zip | 73701-5951
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Country | US
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Telephone | 580-233-3230
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Fax | 580-233-0698
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Authorized Official
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Title or Position | MANAGING/TREATING PHYSICIAN
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Name | DR. TROY ALBERT RICHARDS
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Credential | MD
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Telephone | 580-233-3230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State | OK
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