Provider Demographics
NPI:1811984719
Name:WILLIAMS, JOHN MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:WILLIAMS
Suffix:
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 1:3200 QUAIL SPRINGS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-2699
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:405-241-3194
Practice Address - Street 1:3200 QUAIL SPRINGS PKWY STE 200
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-2699
Practice Address - Country:US
Practice Address - Phone:405-701-9880
Practice Address - Fax:405-241-3194
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18456207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100138120AMedicaid
OK100138120AMedicaid
OK100138120AMedicaid
OKG02563Medicare UPIN
OK24H616553Medicare PIN
OKOKA100664Medicare PIN