NPI Code Details Logo

NPI 1821060831

NPI 1821060831 : WILLIAM D SPENCE MD : BETHANY, OK

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1821060831
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    WILLIAM D SPENCE MD
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    02/03/2006
-----------------------------------------------------
    Last Update Date     |    08/03/2015
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    7530 NW 23RD ST 
-----------------------------------------------------
    City                 |    BETHANY
-----------------------------------------------------
    State                |    OK
-----------------------------------------------------
    Zip                  |    73008-4921
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    405-787-8550
-----------------------------------------------------
    Fax                  |    405-787-8533
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    7530 NW 23RD ST 
-----------------------------------------------------
    City                 |    BETHANY
-----------------------------------------------------
    State                |    OK
-----------------------------------------------------
    Zip                  |    73008-4942
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    405-787-8555
-----------------------------------------------------
    Fax                  |    405-787-8533
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207Q00000X
-----------------------------------------------------
    Taxonomy Name        |    Family Medicine Physician
-----------------------------------------------------
    License Number       |    12269
-----------------------------------------------------
    License Number State |    OK
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.