Individual
WILLARD PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 S PARK LN, ALTUS, OK 73521-5733
(580) 482-9020
(580) 480-3113
Mailing address
5300 N INDEPENDENCE AVE, SUITE 280, OKLAHOMA CITY, OK 73112-5556
(580) 482-9020
(580) 480-3113
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24679
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200070130A
—
OK
05
—
200070130B
—
OH
Enumeration date
06/05/2006
Last updated
02/08/2016
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