Wyatt Williams O.D. Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

WYATT WILLIAMS O.D. INC

Practice address

17900 S Muskogee Ave
Tahlequah, OK 74464-5494

Phone

(918) 207-0700

Fax

(918) 207-0211

NPI assigned

Jul 24, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wyatt Ray WilliamsNPI 1750766325

Title

Owner/Optometrist

Phone

(918) 207-0700

Specialties & licenses 1

Addresses

Other names 1

• Keys Eye Care Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wyatt Williams, O.D.

  • Optometrist
  • Tahlequah, OK
  • NPI 1750766325
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1528443199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17900 S MUSKOGEE AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744645494",
            "telephone_number": "918-207-0700",
            "fax_number": "918-207-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17900 S MUSKOGEE AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744645494",
            "telephone_number": "918-207-0700",
            "fax_number": "918-207-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYATT WILLIAMS O.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-24",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "WYATT",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "918-207-0700"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keys Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William George Worthington, CRNA
• Wrap Project Inc
• Brian Ray Wren, PHARM.D.
• Deanna Elizabeth Wright, ARNP
• Wyatt Speech Therapy Services, PLLC
• Kippi D Wyatt, OD
• Ashley Yadon
• Martha Cecilia Yanci Torres, MD
• Seth David Yandell, M.D.
• Susan Yeutter

• Optometrist in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.