Provider Demographics
NPI:1306020482
Name:WILLIAM P TRUELS MD INC
Entity Type:Organization
Organization Name:WILLIAM P TRUELS MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:TRUELS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-607-8228
Mailing Address - Street 1:4025 SPYGLASS ROAD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120
Mailing Address - Country:US
Mailing Address - Phone:405-607-8228
Mailing Address - Fax:405-607-8236
Practice Address - Street 1:5701 N PORTLAND
Practice Address - Street 2:SUITE 120
Practice Address - City:OKLA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-1670
Practice Address - Country:US
Practice Address - Phone:405-951-4110
Practice Address - Fax:405-951-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-24
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK103862083P0011X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100734660AMedicaid
OKOKB0026Medicare PIN
OK100734660AMedicaid