MEDICARE: WILLIAM P TRUELS MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083P0011X	Undersea and Hyperbaric Medicine (Preventive Medicine) Physician	10386	OK
2	208600000X	Surgery Physician	10386	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306020482
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM P TRUELS MD INC

Provider Business Mailing Address
First Line	:	4025 SPYGLASS ROAD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120
Country	:	US
Telephone Number	:	405-607-8228
Fax Number	:	405-607-8236

Provider Business Practice Location Address
First Line	:	5701 N PORTLAND
Second Line	:	SUITE 120
City	:	OKLA CITY
State	:	OK
Zip	:	73112-1670
Country	:	US
Telephone Number	:	405-951-4110
Fax Number	:	405-951-4111

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WILLIAM PAUL TRUELS
Credential	:	M.D.
Telephone Number	:	405-607-8228

Provider Enumeration Date	:	12/24/2007
Last Update Date	:	08/25/2011

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