Individual
KYLE W RICKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11 PALM AVE, YUKON, OK 73099-5645
(405) 350-5140
Mailing address
1820 COMMONS CR, SUITE A, YUKON, OK 73099-9518
(405) 265-2778
(405) 494-7274
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21266
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100256110A
—
OK
Enumeration date
08/12/2006
Last updated
03/17/2016
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