Provider Demographics
NPI:1396367546
Name:WILLIAMS, VESTER JOE II (PARAMEDIC)
Entity Type:Individual
Prefix:MR
First Name:VESTER
Middle Name:JOE
Last Name:WILLIAMS
Suffix:II
Gender:M
Credentials:PARAMEDIC
Other - Prefix:MR
Other - First Name:VESTER
Other - Middle Name:JOE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PARAMEDIC
Mailing Address - Street 1:PO BOX 939
Mailing Address - Street 2:
Mailing Address - City:MOUNDS
Mailing Address - State:OK
Mailing Address - Zip Code:74047-0939
Mailing Address - Country:US
Mailing Address - Phone:918-650-3161
Mailing Address - Fax:
Practice Address - Street 1:101 E 9TH
Practice Address - Street 2:
Practice Address - City:WELEETKA
Practice Address - State:OK
Practice Address - Zip Code:74880
Practice Address - Country:US
Practice Address - Phone:918-650-3161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK54010146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty