Healthcare Provider Details

I. General information

NPI: 1720091663
Provider Name (Legal Business Name): DAVID C WILLIAMS MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 11/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1553 N PORTER AVE
NORMAN OK
73071-6621
US

IV. Provider business mailing address

1553 N PORTER AVE
NORMAN OK
73071-6621
US

V. Phone/Fax

Practice location:
  • Phone: 405-217-8500
  • Fax: 405-217-8501
Mailing address:
  • Phone: 405-217-8500
  • Fax: 405-217-8501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number22399
License Number StateOK

VIII. Authorized Official

Name: DAVID COLLIER WILLIAMS
Title or Position: OWNER
Credential: M.D.
Phone: 405-217-8500