MEDICARE: DR. BRIAN F WILLIAMS O.D.

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	152W00000X	Optometrist	2147	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00332663	OTHER	OK	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	242314200005	OTHER	OK	BLUE CROSS & BLUE SHIELD
2	1411421	OTHER	OK	AETNA
3	5458275	OTHER	OK	AETNA HMO
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902802895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN F WILLIAMS O.D.

Provider Business Mailing Address
First Line	:	10010 E. 81ST ST
Second Line	:	#100
City	:	TULSA
State	:	OK
Zip	:	74133-5726
Country	:	US
Telephone Number	:	918-250-2020
Fax Number	:	918-250-8910

Provider Business Practice Location Address
First Line	:	10010 E. 81ST ST
Second Line	:	#100
City	:	TULSA
State	:	OK
Zip	:	74133-5726
Country	:	US
Telephone Number	:	918-250-2020
Fax Number	:	918-250-8910

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	06/15/2009

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Directions to “ DR. BRIAN F WILLIAMS O.D.” Practice Location

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