Individual
RICHARD LEE BOOTHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
608 NW 9TH ST, SUITE 1100, OKLAHOMA CITY, OK 73102-1068
(405) 231-3000
(405) 231-3073
Mailing address
PO BOX 269064, OKLAHOMA CITY, OK 73126-9064
(405) 231-3857
(405) 272-7977
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16758
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100111810B
—
OK
Enumeration date
07/11/2006
Last updated
10/20/2020
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