Provider Demographics
NPI:1457823684
Name:MAGER, WILLIAM ALBERT
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ALBERT
Last Name:MAGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 NW 43RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-8731
Mailing Address - Country:US
Mailing Address - Phone:405-822-7597
Mailing Address - Fax:
Practice Address - Street 1:2300 NW 43RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-8731
Practice Address - Country:US
Practice Address - Phone:405-822-7597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist