Provider Demographics
NPI:1457783656
Name:ASSOCIATES OF MEDICINE,JOHN D WILLIAMS,MD,PLLC
Entity Type:Organization
Organization Name:ASSOCIATES OF MEDICINE,JOHN D WILLIAMS,MD,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-377-8000
Mailing Address - Street 1:608 S HESTER ST
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-4516
Mailing Address - Country:US
Mailing Address - Phone:405-377-8000
Mailing Address - Fax:405-377-8040
Practice Address - Street 1:608 S HESTER ST
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4516
Practice Address - Country:US
Practice Address - Phone:405-377-8000
Practice Address - Fax:405-377-8040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200235260AMedicaid
OK200235260AMedicaid