Provider Demographics
NPI:1578050571
Name:RICHARD, BHAVITHA GEORGE (MD)
Entity type:Individual
Prefix:DR
First Name:BHAVITHA
Middle Name:GEORGE
Last Name:RICHARD
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1923 S UTICA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-6520
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7501 RIVERSIDE PKWY
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-5056
Practice Address - Country:US
Practice Address - Phone:918-710-4200
Practice Address - Fax:918-403-6331
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO67637207Q00000X
OK33878207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK10017697OtherOK BUREAU OF NARCOTICS AND DANGEROUS DRUGS
OK33878OtherOK MEDICAL LICENSE