Active NPI
Randal A Williams, M.D.
- Family Medicine Physician
- Sulphur, OK
National Provider Identifier
1124068366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20799
- Practice address
- 220 W Vinita Ave
Sulphur, OK 73086-3805 - Phone
- (580) 622-5451
- Fax
- (580) 622-5480
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20799 | OK | Primary |
Addresses
Primary practice location
220 W Vinita Ave
Sulphur, OK 73086-3805
Mailing address
220 W Vinita Ave
Sulphur, OK 73086-3805
Phone (580) 622-5451
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080158623 | Other | OK | RAILROAD MEDICARE |
| 175735100 | Other | OK | US DEPT OF LABOR |
| 100137300B | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20799 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson County Memorial Hospital Authority | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Altus, OK
- NPI 1093763781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246838400000",
"number": "1124068366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 W VINITA AVE",
"city": "SULPHUR",
"state": "OK",
"postal_code": "730863805",
"telephone_number": "580-622-5451",
"fax_number": "580-622-5480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 W VINITA AVE",
"city": "SULPHUR",
"state": "OK",
"postal_code": "730863805",
"telephone_number": "580-622-5451",
"fax_number": "580-622-5480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "RANDAL",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2009-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "20799",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080158623",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US DEPT OF LABOR",
"identifier": "175735100",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100137300B",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sulphur, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.