Individual
WILLIAM ROBERT ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
700 N MAIN, GORE, OK 74435
(918) 489-5757
(918) 489-5411
Mailing address
PO BOX 479, GORE, OK 74435
(918) 489-5757
(918) 489-5411
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2597
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100257880A
—
OK
05
—
100257880C
—
OK
05
—
100257880E
—
OK
Enumeration date
08/09/2005
Last updated
12/27/2011
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