Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 19801 | PR |
NPI | 1063472603 |
---|---|
Provider Name | William Dewey Lei |
First Address | Oklahoma City, OK 73126-8947 |
Second Address | Oklahoma City, OK 73162-6006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 05/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100156160A | (05) | OK |
G46165 | (02) | OK |
P00247931 | RR MEDICARE (01) | OK |