Provider Demographics
NPI:1225239155
Name:HASTINGS, RICHARD ALLEN II (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALLEN
Last Name:HASTINGS
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4619 S HARVARD AVE STE F
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2920
Mailing Address - Country:US
Mailing Address - Phone:918-749-1720
Mailing Address - Fax:918-746-0674
Practice Address - Street 1:5606 SW LEE BLVD STE 305
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-9618
Practice Address - Country:US
Practice Address - Phone:580-531-4028
Practice Address - Fax:580-531-4027
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2094207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKE09805Medicare UPIN