Individual
FREDERICK W WILLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 744-2345
Mailing address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 744-2345
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
0101052684
VA
2085R0001X
Radiation Oncology Physician
Primary
20141
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146643
ANTHEM BCBS
—
01
—
2129632
MAMSI
—
01
—
248895
SOUTHERN HEALTH
—
01
—
3735116
AETNA
—
01
—
8646817
CIGNA
—
01
—
P00214553
RAILROAD MEDICARE
—
Enumeration date
03/14/2006
Last updated
07/08/2007
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