Individual
WILLIAM EDWIN GUPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1401 E VAN BUREN AVE, MCALESTER, OK 74501-4245
(918) 426-0240
(918) 423-4051
Mailing address
PO BOX 908, MCALESTER, OK 74502-0908
(918) 426-0240
(918) 423-4051
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12190
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0166707
UMWA
OK
01
—
1324230001
PALMETTO DME
OK
01
—
731310891006
UNICARE
OK
01
—
731310891028
TRICARE SOUTH
OK
01
—
74502A008
CHAMPUS
OK
01
—
D39156
STERLING OPTION 1
OK
Enumeration date
04/10/2006
Last updated
04/14/2008
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