Healthcare Provider Details

I. General information

NPI: 1760873020
Provider Name (Legal Business Name): RACHEL D WITMER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL D CRAIL PA-C

II. Dates (important events)

Enumeration Date: 02/09/2015
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 HEALTHPLEX PKWY
NORMAN OK
73072-9749
US

IV. Provider business mailing address

PO BOX 269065
OKLAHOMA CITY OK
73126-9065
US

V. Phone/Fax

Practice location:
  • Phone: 405-515-1000
  • Fax:
Mailing address:
  • Phone: 405-307-1600
  • Fax: 405-307-1604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2655
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: