Individual
DR. CLINTON WILLIAMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3433 NW 56TH ST, SUITE C-40, OKLAHOMA CITY, OK 73112-4455
(405) 945-4741
(888) 972-5320
Mailing address
3433 NW 56TH ST, SUITE C-40, OKLAHOMA CITY, OK 73112-4455
(405) 945-4741
(888) 972-5320
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25121
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200246060A
—
OK
01
—
P00840510
MEDICARE RAILROAD
OK
01
—
P00860908
MEDICARE RAILROAD MPI
OK
Enumeration date
05/18/2007
Last updated
06/14/2021
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