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General NPI Number Information
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NPI Number | 1366874190
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Entity Type | Individual
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Provider Name | TIM B. WILLIAMSON C.AC.
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Gender | Male
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Dates
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Enumeration Date | 08/03/2013
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Last Update Date | 08/11/2018
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Provider Practice Location Address
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Address Line | 608 W 41ST ST
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City | SAND SPRINGS
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State | OK
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Zip | 74063
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Country | US
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Telephone | 918-694-1517
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Fax | 918-241-9600
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Provider Business Mailing Address
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Address Line | 608 W 41ST ST
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City | SAND SPRINGS
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State | OK
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Zip | 74063-2611
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Country | US
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Telephone | 918-694-1517
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Fax | 918-241-9600
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | OK1016
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License Number State | OK
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