Provider Demographics
NPI:1922070317
Name:BEVERS, WILLIAM S (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:S
Last Name:BEVERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10021 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-2927
Mailing Address - Country:US
Mailing Address - Phone:405-692-9300
Mailing Address - Fax:405-691-0062
Practice Address - Street 1:10021 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2927
Practice Address - Country:US
Practice Address - Phone:405-692-9300
Practice Address - Fax:405-691-0062
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK16120207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK080144457OtherRAILROAD MEDICARE
OKE18015Medicare UPIN
OK100137130AMedicaid