Individual
DOUGLAS RYAN RIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4509 INTEGRIS PKWY STE 200, EDMOND, OK 73034-8696
(405) 657-3950
(405) 471-0040
Mailing address
5300 N INDEPENDENCE AVE, SUITE 280, OKLAHOMA CITY, OK 73112-5556
(405) 657-3950
(405) 471-0040
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23957
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200079200A
—
OK
Enumeration date
06/05/2006
Last updated
07/21/2022
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