Provider Demographics
NPI:1487698031
Name:SEIFERT, RICHARD WEBER (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WEBER
Last Name:SEIFERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 SOUTH UTICA
Mailing Address - Street 2:SUITE 909
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4005
Mailing Address - Country:US
Mailing Address - Phone:918-584-0123
Mailing Address - Fax:918-573-5269
Practice Address - Street 1:1145 S UTICA AVE
Practice Address - Street 2:SUITE 909
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4005
Practice Address - Country:US
Practice Address - Phone:918-584-0123
Practice Address - Fax:918-583-5269
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11516207RG0100X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist