Provider Demographics
NPI:1689678245
Name:ALLGOOD, RICHARD JENE (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JENE
Last Name:ALLGOOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5404 SW LEE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-9521
Mailing Address - Country:US
Mailing Address - Phone:580-536-7528
Mailing Address - Fax:580-536-3571
Practice Address - Street 1:5404 SW LEE BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-9521
Practice Address - Country:US
Practice Address - Phone:580-536-7528
Practice Address - Fax:580-536-3571
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK83122086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKD34332Medicare UPIN