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General NPI Number Information
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NPI Number | 1134590771
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Entity Type | Individual
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Provider Name | WILLIAM CLABORN R.N.
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Gender | Male
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Dates
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Enumeration Date | 10/08/2015
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Last Update Date | 10/08/2015
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Provider Practice Location Address
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Address Line | 715 W SHAWNTEL SMITH BLVD
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City | MULDROW
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State | OK
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Zip | 74948-4013
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Country | US
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Telephone | 918-427-3316
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Fax | 918-427-1033
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Provider Business Mailing Address
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Address Line | PO BOX 550
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City | MULDROW
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State | OK
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Zip | 74948-0550
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Country | US
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Telephone | 918-427-3316
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Fax | 918-427-1033
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | R 0071361
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License Number State | OK
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