Provider Demographics
NPI:1417759473
Name:MUELLER, WILLIAM JERRY (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JERRY
Last Name:MUELLER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 E 19TH ST STE 703
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5418
Mailing Address - Country:US
Mailing Address - Phone:918-382-3178
Mailing Address - Fax:918-382-6789
Practice Address - Street 1:1705 E 19TH ST STE 703
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5418
Practice Address - Country:US
Practice Address - Phone:918-382-3178
Practice Address - Fax:918-382-6789
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program