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NPI Code Detail

MEDICARE: WENDELL L RICHARDS DO

MEDICARE: WENDELL L RICHARDS DO
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
1207Q00000XFamily Medicine Physician2298OK

General Provider Information

NPI Number : 1588656292
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDELL L RICHARDS DO
Provider Business Mailing Address
First Line : PO BOX 258884
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73125-8884
Country : US
Telephone Number : 405-231-3857
Fax Number : 405-272-7977
Provider Business Practice Location Address
First Line : 114 N HIGHWAY 18
Second Line :
City : CHANDLER
State : OK
Zip : 74834-1200
Country : US
Telephone Number : 405-258-2500
Fax Number : 405-258-3053
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2005
Last Update Date : 11/11/2016

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Directions to “ WENDELL L RICHARDS DO” Practice Location

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