Provider Demographics
NPI:1619393428
Name:WILLIAMS, NORMAN SR
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:
Last Name:WILLIAMS
Suffix:SR
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 1:5850 NW DEARBORN AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-5731
Mailing Address - Country:US
Mailing Address - Phone:580-483-4206
Mailing Address - Fax:
Practice Address - Street 1:5850 NW DEARBORN AVE
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-5731
Practice Address - Country:US
Practice Address - Phone:580-483-4206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor