Individual
TYRUN KEITH RICHARDSON
Active
Individual
TYRUN KEITH RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
04-33531
KS
208800000X
Urology Physician
Primary
2016012292
MO
208800000X
Urology Physician
31026
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200456750H
—
OK
05
—
200566690A
—
OK
05
—
200615150A
—
KS
05
—
PENDING
—
AR
05
—
PENDING
—
MO
Enumeration date
07/14/2005
Last updated
06/16/2016
Update your record
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