Individual
MARK LYNN RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
9600 BROADWAY EXT, OKLAHOMA CITY, OK 73114-7408
(405) 715-3610
(405) 715-3612
Mailing address
PO BOX 13618, OKLAHOMA CITY, OK 73113-1618
(405) 715-3610
(405) 715-3612
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0035247
OK
Other
Enumeration date
06/30/2006
Last updated
02/25/2011
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