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820 W Danforth Rd B-30 Edmond OK 73003-5006 | |
| (405) 602-3553 | |
| (405) 602-3556 |
| Full Name | |
|---|---|
| Speciality | Hospitalist |
| Location | 820 W Danforth Rd, Edmond, Oklahoma |
| Authorized Official Name and Position | Lance Williams (PRESIDENT) |
| Authorized Official Contact | 8656931000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1643 Nw 136th Ave Ste 100 Sunrise FL 33323-2857 Ph: (800) 424-3672 | 820 W Danforth Rd B-30 Edmond OK 73003-5006 Ph: (405) 602-3553 |
| NPI Number | 1144274655 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 10/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144274655 | NPI | - | NPPES |
| 200027400A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208M00000X | Hospitalist | (* (Not Available)) | Primary |
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