Basic Information
Provider Information
NPI: 1932513728
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WILLIAMS
FirstName: RHETT
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 608 NW 9TH ST STE 6210
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731021069
CountryCode: US
TelephoneNumber: 4052729641
FaxNumber: 4052350738
Practice Location
Address1: 1000 N LEE AVE
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731021036
CountryCode: US
TelephoneNumber: 4052729641
FaxNumber: 4052350738
Other Information
ProviderEnumerationDate: 06/19/2014
LastUpdateDate: 12/16/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/16/2019

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XBP10054573TXN Allopathic & Osteopathic PhysiciansAnesthesiology 
207R00000X7219NEN Allopathic & Osteopathic PhysiciansInternal Medicine 
207L00000X33956OKY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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