Individual
RICARDO BERNARD MADISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
1109 NE 59TH ST, OKLAHOMA CITY, OK 73111-7401
(405) 823-3737
(405) 748-0468
Mailing address
1109 NE 59TH ST, OKLAHOMA CITY, OK 73111-7401
(405) 823-3737
(405) 748-0468
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
251B00000X
OK
Other
Enumeration date
08/29/2011
Last updated
08/29/2011
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