Individual provider · Type 1 NPI

Timothy Jace Richardson, PA

Medical Physician Assistant · Oklahoma City, OK

NPI number 1487329603 Active

Practice location

921 NE 13th St
Oklahoma City, OK 73104-5007

Call (405) 456-1000 Map

Mailing address

25 Bryant St
Ward, AR 72176-8520

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1487329603

Timothy Jace Richardson, PA's National Provider Identifier is 1487329603, issued on Aug 10, 2021. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Oklahoma City, OK. The record was last updated on Aug 10, 2021.