Provider Demographics
NPI:1164411526
Name:SCHAFER, RICHARD WRIGHT (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WRIGHT
Last Name:SCHAFER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:601 S HARBOUR ISLAND BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5925
Mailing Address - Country:US
Mailing Address - Phone:800-480-5243
Mailing Address - Fax:800-928-7449
Practice Address - Street 1:222 N MAIN ST
Practice Address - Street 2:300 N MAIN ST
Practice Address - City:BRISTOW
Practice Address - State:OK
Practice Address - Zip Code:74010-2408
Practice Address - Country:US
Practice Address - Phone:918-367-6533
Practice Address - Fax:918-367-6544
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2023-08-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK3218207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200507290AMedicaid
OK100231410AMedicaid
OK100231410AMedicaid
OKF82844Medicare UPIN