Provider Demographics
NPI:1619976750
Name:HROMAS, RICHARD L (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:L
Last Name:HROMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:580-233-9012
Mailing Address - Fax:580-249-4269
Practice Address - Street 1:1805 W GARRIOTT RD
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-5526
Practice Address - Country:US
Practice Address - Phone:580-233-9012
Practice Address - Fax:580-249-4269
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12215207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP00154830OtherRR MEDICARE
OK100089120AMedicaid
OKP00154830OtherRR MEDICARE
OKP00765898Medicare PIN
OKOK402626Medicare PIN
OK241412213Medicare PIN