Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | LO41 | OK |
N | 222Z00000X | Podiatrist | LO41 | OK |
Y | 224P00000X | Prosthetist | LP39 | OK |
NPI | 1386881035 |
---|---|
Provider Name | Mr. Richard L Foster |
First Address | Edmond, OK 73034-3822 |
Second Address | Edmond, OK 73034-3822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2009 |
Last Update Date | 17/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200625420A | (05) | OK |