Provider Demographics
NPI:1346746690
Name:RICHBURG, KACY ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:KACY
Middle Name:ANNE
Last Name:RICHBURG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:800 STANTON L YOUNG BLVD STE 3400
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5018
Mailing Address - Country:US
Mailing Address - Phone:405-271-5964
Mailing Address - Fax:405-271-3461
Practice Address - Street 1:711 STANTON L YOUNG BLVD STE 111
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104
Practice Address - Country:US
Practice Address - Phone:405-271-4906
Practice Address - Fax:405-271-4910
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK33849207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery