Provider Demographics
NPI:1063472603
Name:LEI, WILLIAM DEWEY (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DEWEY
Last Name:LEI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 268947
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73126-8947
Mailing Address - Country:US
Mailing Address - Phone:405-751-4664
Mailing Address - Fax:405-749-4561
Practice Address - Street 1:8325 NW EXPRESSWAY ST
Practice Address - Street 2:C/O MERCY AFTER HOURS
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-6006
Practice Address - Country:US
Practice Address - Phone:405-749-7099
Practice Address - Fax:405-749-4561
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19801207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100156160AMedicaid
OKP00247931OtherRR MEDICARE
OKP00247931OtherRR MEDICARE
OKG46165Medicare UPIN