Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 20827 | OK |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 20827 | OK |
NPI | 1770581506 |
---|---|
Provider Name | Dr. William Bentley Edmonds |
First Address | Oklahoma City, OK 73114-7408 |
Second Address | Oklahoma City, OK 73114-7408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 23/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200009820A | (05) | OK |
H60311 | (02) |