Provider Demographics
NPI:1104856350
Name:SHERRIE G. WILLIAMSON DO, PLLC
Entity Type:Organization
Organization Name:SHERRIE G. WILLIAMSON DO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:405-701-1010
Mailing Address - Street 1:3201 W TECUMSEH RD
Mailing Address - Street 2:STE. 230
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-1818
Mailing Address - Country:US
Mailing Address - Phone:405-701-1010
Mailing Address - Fax:405-701-1011
Practice Address - Street 1:3201 W TECUMSEH RD
Practice Address - Street 2:STE.230
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-1818
Practice Address - Country:US
Practice Address - Phone:405-701-1010
Practice Address - Fax:405-701-1011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2988207N00000X, 261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK00R08JOtherMEDICARE ID
TXF07078Medicare UPIN
TX00668RMedicare ID - Type Unspecified
OK00R08JOtherMEDICARE ID