Healthcare Provider Details

I. General information

NPI: 1033506704
Provider Name (Legal Business Name): WILLIAM AUSTIN DOSS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2015
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 N PORTLAND AVE # 600
OKLAHOMA CITY OK
73112-2121
US

IV. Provider business mailing address

5300 N INDEPENDENCE AVE STE 280
OKLAHOMA CITY OK
73112-5555
US

V. Phone/Fax

Practice location:
  • Phone: 405-713-9941
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number6927
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: