Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 22490 | OK |
N | 111NI0900X | Internist | 22490 | OK |
Y | 207RH0002X | Hospice and Palliative Medicine | 22490 | OK |
NPI | 1235190448 |
---|---|
Provider Name | Nancy Williams |
First Address | Elk City, OK 73648-2339 |
Second Address | Tulsa, OK 74104-5405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2006 |
Last Update Date | 16/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200026690A | (05) | OK |
I06949 | (02) | OK |