Individual
MARK A WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
9600 BROADWAY EXT, OKLAHOMA CITY, OK 73114-7408
(405) 715-3610
Mailing address
PO BOX 13618, OKLAHOMA CITY, OK 73113-1618
(405) 715-3610
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0053020
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100785180A
—
OK
Enumeration date
07/12/2006
Last updated
03/22/2011
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