Healthcare Provider Details

I. General information

NPI: 1427974930
Provider Name (Legal Business Name): WILLIAM ROGERS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16281 S 321ST EAST AVE
COWETA OK
74429-3062
US

IV. Provider business mailing address

16281 S 321ST EAST AVE
COWETA OK
74429-3062
US

V. Phone/Fax

Practice location:
  • Phone: 918-282-2284
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberOK1409
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: