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NPI Code Detail

MEDICARE: JERRY JOE RICHTER

MEDICARE: JERRY JOE RICHTER
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1699617183
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERRY JOE RICHTER
Provider Business Mailing Address
First Line : 3778 N NICKLAS AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73122-2416
Country : US
Telephone Number : 405-232-9804
Fax Number :
Provider Business Practice Location Address
First Line : 301 W I 240 SERVICE RD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73139-7701
Country : US
Telephone Number : 405-232-9804
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2026
Last Update Date : 04/06/2026

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Directions to “ JERRY JOE RICHTER ” Practice Location

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