Provider Demographics
NPI:1518960459
Name:FALK, RICHARD G JR (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:G
Last Name:FALK
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 NW 56TH ST
Mailing Address - Street 2:STE 206
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4426
Mailing Address - Country:US
Mailing Address - Phone:405-945-4740
Mailing Address - Fax:405-945-4751
Practice Address - Street 1:3330 NW 56TH ST
Practice Address - Street 2:STE 206
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4426
Practice Address - Country:US
Practice Address - Phone:405-945-4740
Practice Address - Fax:405-945-4751
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK149022085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP00199971OtherRAILROAD MEDICARE
OKP00199971OtherRAILROAD MEDICARE
OKE29103Medicare UPIN