MEDICARE: WILLIAMS MEDICAL GROUP PRACTICE, LLC

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	207Q00000X	Family Medicine Physician
2	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1558931303
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAMS MEDICAL GROUP PRACTICE, LLC

Provider Business Mailing Address
First Line	:	701 CEDAR LAKE BLVD STE 120
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-7815
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1817 ARLINGTON ST
Second Line	:
City	:	ADA
State	:	OK
Zip	:	74820-2814
Country	:	US
Telephone Number	:	580-279-0985
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	GRANT ASAY
Credential	:
Telephone Number	:	405-445-1210

Provider Enumeration Date	:	06/24/2021
Last Update Date	:	02/24/2023

Similar Medicare Providers

1750677159 — DR. BENJAMIN FRANKLIN EDWARDS III D.D.S.
Practice Location Address:

1801 ARLINGTON ST
ADA, OK
74820-2814

Practice Phone: 580-332-1660
Practice Fax:

1316347016 — ADA SMILE PLACE, PLLC
Practice Location Address:

1801 ARLINGTON ST
ADA, OK
74820-2814

Practice Phone: 580-332-1660
Practice Fax: 580-421-9009

1659849420 — DEIRDRENEY ANDRIA HARRIS NP
Practice Location Address:

1817 ARLINGTON ST
ADA, OK
74820-2814

Practice Phone: 580-279-0985
Practice Fax: 858-461-6008

1952903528 — LINDSEY EDWARDS RDH
Practice Location Address:

1801 ARLINGTON ST
ADA, OK
74820-2814

Practice Phone: 580-332-1660
Practice Fax:

1649133471 — CHASE LOTT
Practice Location Address:

1921 STONECIPHER DR
ADA, OK
74820-3439

Practice Phone: 580-421-4550
Practice Fax: 580-421-6286

1063375715 — BRIAN ANDREW HINKLE PHARM. D.
Practice Location Address:

1921 STONECIPHER DR
ADA, OK
74820-3439

Practice Phone: 580-436-3980
Practice Fax:

Directions to “WILLIAMS MEDICAL GROUP PRACTICE, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.