Provider Demographics
NPI:1821041997
Name:DOSS, RICHARD A (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:DOSS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1245 S UTICA AVE
Mailing Address - Street 2:STE 303
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4214
Mailing Address - Country:US
Mailing Address - Phone:918-382-2510
Mailing Address - Fax:918-382-2545
Practice Address - Street 1:1725 E 19TH ST
Practice Address - Street 2:SUITE 501
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5437
Practice Address - Country:US
Practice Address - Phone:918-748-6990
Practice Address - Fax:918-748-7578
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2018-07-24
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Provider Licenses
StateLicense IDTaxonomies
OK9914207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100159930AMedicaid
OK100159930AMedicaid
C94866Medicare UPIN