Healthcare Provider Details

I. General information

NPI: 1629015763
Provider Name (Legal Business Name): WILLIAM MARTIN SCHNITZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 04/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 NW 58TH ST STE 804
OKLAHOMA CITY OK
73112-4703
US

IV. Provider business mailing address

3555 NW 58TH ST STE 804
OKLAHOMA CITY OK
73112-4703
US

V. Phone/Fax

Practice location:
  • Phone: 405-548-0430
  • Fax: 405-463-4408
Mailing address:
  • Phone: 405-548-0430
  • Fax: 405-463-4408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number16521
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number16521
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: