Provider Demographics
NPI:1598904484
Name:WILLIAM M FEATHERSTON, M.D., P.C.
Entity Type:Organization
Organization Name:WILLIAM M FEATHERSTON, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:FEATHERSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:580-225-2203
Mailing Address - Street 1:1925 W 3RD ST
Mailing Address - Street 2:P.O. BOX 1129
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73644-4303
Mailing Address - Country:US
Mailing Address - Phone:580-225-2203
Mailing Address - Fax:580-225-5013
Practice Address - Street 1:1925 W 3RD ST
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-4303
Practice Address - Country:US
Practice Address - Phone:580-225-2203
Practice Address - Fax:580-225-5013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5942208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100140470AMedicaid
450262840OtherMEDICARE
1104915529OtherNPI
OK5942OtherOKLAHOMA MEDICAL LICENSE
OK5942OtherOKLAHOMA MEDICAL LICENSE
OKD34627Medicare UPIN