Provider Demographics
NPI:1669427464
Name:WILLIAMS, CHAD GREGORY (DC)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:GREGORY
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E HIGHWAY 70
Mailing Address - Street 2:
Mailing Address - City:WAURIKA
Mailing Address - State:OK
Mailing Address - Zip Code:73573-3075
Mailing Address - Country:US
Mailing Address - Phone:580-228-2000
Mailing Address - Fax:580-228-2912
Practice Address - Street 1:104 E HIGHWAY 70
Practice Address - Street 2:
Practice Address - City:WAURIKA
Practice Address - State:OK
Practice Address - Zip Code:73573-3075
Practice Address - Country:US
Practice Address - Phone:580-228-2000
Practice Address - Fax:580-228-2912
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3728111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor