Healthcare Provider Details

I. General information

NPI: 1063472603
Provider Name (Legal Business Name): WILLIAM DEWEY LEI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 08/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8325 NW EXPRESSWAY ST C/O MERCY AFTER HOURS
OKLAHOMA CITY OK
73162-6006
US

IV. Provider business mailing address

PO BOX 268947
OKLAHOMA CITY OK
73126-8947
US

V. Phone/Fax

Practice location:
  • Phone: 405-749-7099
  • Fax: 405-749-4561
Mailing address:
  • Phone: 405-751-4664
  • Fax: 405-749-4561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number19801
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: