Provider Demographics
NPI:1720015415
Name:HARRIS, WILLIAM KEITH II (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:KEITH
Last Name:HARRIS
Suffix:II
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 1:8803 S 101ST EAST AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5726
Mailing Address - Country:US
Mailing Address - Phone:918-858-0008
Mailing Address - Fax:918-858-0074
Practice Address - Street 1:8803 S 101ST EAST AVE STE 245
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5730
Practice Address - Country:US
Practice Address - Phone:918-858-0008
Practice Address - Fax:918-858-0074
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19482207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100091040CMedicaid
OKOKAAA1975Medicare PIN
OKG72114Medicare UPIN
OK800522021Medicare ID - Type Unspecified