Provider Demographics
NPI:1902802895
Name:WILLIAMS, BRIAN F (OD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:F
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:10010 E. 81ST ST
Mailing Address - Street 2:#100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5726
Mailing Address - Country:US
Mailing Address - Phone:918-250-2020
Mailing Address - Fax:918-250-8910
Practice Address - Street 1:10010 E. 81ST ST
Practice Address - Street 2:#100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5726
Practice Address - Country:US
Practice Address - Phone:918-250-2020
Practice Address - Fax:918-250-8910
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-24
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2147152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK242314200005OtherBLUE CROSS & BLUE SHIELD
OK1411421OtherAETNA
OK5458275OtherAETNA HMO
OK100761750AMedicaid
OKP00332663OtherRAILROAD MEDICARE
OK242314200005OtherBLUE CROSS & BLUE SHIELD
OK5458275OtherAETNA HMO