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General NPI Number Information
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NPI Number | 1376769422
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Entity Type | Individual
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Provider Name | VICTOR OWEN WATERS M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 120 SOUTH 'B' STREET
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City | SKIATOOK
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State | OK
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Zip | 74070-1539
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Country | US
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Telephone | 918-230-2193
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Fax | 918-396-7319
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Provider Business Mailing Address
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Address Line | 120 SOUTH 'B' STREET
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City | SKIATOOK
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State | OK
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Zip | 74070-1539
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Country | US
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Telephone | 918-230-2193
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Fax | 918-396-7319
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 17315
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 9275
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 9275
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 17315
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License Number State | CO
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Taxonomy #5
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 9275
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License Number State | OK
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Taxonomy #6
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 17315
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License Number State | CO
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