Provider Demographics
NPI:1770564312
Name:MORGAN, WILLIAM GREGORY III (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GREGORY
Last Name:MORGAN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:GREGORY
Other - Last Name:MORGAN
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6608 N WESTERN AVE # 493
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-7326
Mailing Address - Country:US
Mailing Address - Phone:405-418-4800
Mailing Address - Fax:405-418-4820
Practice Address - Street 1:1705 RENAISSANCE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3041
Practice Address - Country:US
Practice Address - Phone:405-682-8383
Practice Address - Fax:405-682-8044
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10222207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100064720BMedicaid
OK100064720BMedicaid
OK$$$$$$$$$RMedicare PIN