Healthcare Provider Details

I. General information

NPI: 1538335245
Provider Name (Legal Business Name): THOMAS J. WILLIAMS, O.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2008
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 N 16TH AVE
DURANT OK
74701-3607
US

IV. Provider business mailing address

PO BOX 910
DURANT OK
74702-0910
US

V. Phone/Fax

Practice location:
  • Phone: 580-924-2730
  • Fax: 580-924-2731
Mailing address:
  • Phone: 580-924-2730
  • Fax: 580-924-2731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS J. WILLIAMS
Title or Position: OWNER
Credential: O.D.
Phone: 580-924-2730