Healthcare Provider Details

I. General information

NPI: 1477003069
Provider Name (Legal Business Name): WILLIAM TODD PARSONS CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2016
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4416 SPYGLASS DRIVE
NORMAN OK
73072-5010
US

IV. Provider business mailing address

4416 SPYGLASS DR
NORMAN OK
73072-8573
US

V. Phone/Fax

Practice location:
  • Phone: 405-473-1980
  • Fax:
Mailing address:
  • Phone: 405-473-1980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number90832
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number90732
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: