Hanson, Richard Enniss

Hanson, Richard Enniss is an individual health care provider with primary practice located at 19416 Cade Ct , Edmond OK 73012-4163. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Hanson, Richard Enniss can be contacted via phone (405) 640-9005.

Contact Information

Primary practice address
19416 Cade Ct Edmond OK 73012-4163
Phone: (405) 640-9005
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1134117153
LBN Legal business name Hanson, Richard Enniss
Credentials PA, MPAS
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2005
Last updated Nov 10th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134117153 NPPES
Oklahoma MEDICAID 200266340A

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