Provider Demographics
NPI:1629015763
Name:SCHNITZ, WILLIAM MARTIN (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:MARTIN
Last Name:SCHNITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3555 NW 58TH ST STE 804
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4703
Mailing Address - Country:US
Mailing Address - Phone:405-548-0430
Mailing Address - Fax:405-463-4408
Practice Address - Street 1:3555 NW 58TH ST STE 804
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4703
Practice Address - Country:US
Practice Address - Phone:405-548-0430
Practice Address - Fax:405-463-4408
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK16521207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100095820BMedicaid
OK100095820BMedicaid
E11744Medicare UPIN