Provider Demographics
NPI:1053483172
Name:BARNES, RICHARD DAVID (ARNP)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:DAVID
Last Name:BARNES
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 S WHEELING AVE
Mailing Address - Street 2:STE 510
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5649
Mailing Address - Country:US
Mailing Address - Phone:918-747-5200
Mailing Address - Fax:918-858-0290
Practice Address - Street 1:2000 S WHEELING AVE STE 510
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5649
Practice Address - Country:US
Practice Address - Phone:918-747-5200
Practice Address - Fax:918-858-0290
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKROO62092163WN0300X
OKR0062092363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WN0300XNursing Service ProvidersRegistered NurseNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100845680AMedicaid
OK100845680AMedicaid