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Individual

DR. RICHARD KENT TICER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
10109 E 79TH ST, TULSA, OK 74133-4564
(918) 286-5000
Mailing address
9543 E 81ST ST, APT 603, TULSA, OK 74133-8110
(918) 994-7134

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2402
OK
207L00000X
Anesthesiology Physician
34-004298T
OH
207L00000X
Anesthesiology Physician
E-2672
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0799695
AR
Enumeration date
05/26/2006
Last updated
09/07/2010
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