Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 2183 | OK |
NPI | 1073571154 |
---|---|
Provider Name | Mr. Richard L Myers |
First Address | Oklahoma City, OK 73112-5556 |
Second Address | Oklahoma City, OK 73112-4418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 05/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100095210A | (05) | OK |
E60291 | (02) | OK |