Richardson, Tyrun Keith
Richardson, Tyrun Keith is an individual health care provider with primary practice located at 1965 S Fremont Ave Ste 370, Springfield MO 65804-2201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Richardson, Tyrun Keith can be contacted via phone (417) 820-0300.Contact Information
Primary practice address
1965 S Fremont Ave Ste 370
Springfield MO 65804-2201
Phone: (417) 820-0300
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 04-33531 | Kansas |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 31026 | Oklahoma |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 2016012292 | Missouri |
Profile Details
| NPI number | 1205834074 |
|---|---|
| LBN Legal business name | Richardson, Tyrun Keith |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2005 |
| Last updated | Jun 16th, 2016 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205834074 | NPPES |
| Missouri | MEDICAID | PENDING | |
| Missouri | MEDICAID | PENDING | |
| Missouri | MEDICAID | 200456750H | |
| Missouri | MEDICAID | 200566690A | |
| Missouri | MEDICAID | 200615150A |
Popular Providers
-
Malossi, Jennifer A
1001 E Primrose St , Springfield MO 65807-5155 -
Milne, Mark J
1001 E Primrose St , Springfield MO 65807-5155 -
Johnson, Robert D.
1965 S Fremont Ave Suite 370, Springfield MO 65804-2201 -
Anderson, David A
1001 E Primrose St , Springfield MO 65807-5155 -
Pearson, Thomas C
1256 S Post Oak Ct , Springfield MO 65809-1624 -
Johnson, Jeffrey R
1965 S Fremont Ave Suite 370, Springfield MO 65804-2201 -
Miller, Brandi Dawn
1965 S Fremont Ave Ste 370 , Springfield MO 65804-2284 -
Farber, Barry S
3850 S National Ave Suite 320, Springfield MO 65807-5287