Individual
DR. RICHARD GREEN ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1103 W CHEROKEE ST, WAGONER, OK 74467-4621
(918) 485-3182
(918) 485-1032
Mailing address
1103 W CHEROKEE ST, WAGONER, OK 74467-4621
(918) 485-3182
(918) 485-1032
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2843
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100073940A
—
OK
05
—
100073940D
—
OK
Enumeration date
11/10/2005
Last updated
04/10/2014
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