Randall J Willis, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

12754 Issued in OK

Practice address

801 S Walnut St
Stillwater, OK 74074-4226

Phone

(405) 743-3760

NPI assigned

Apr 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Cimarron Surgical and Urology

  • Specialist
  • Stillwater, OK
  • NPI 1295864577
  NPD

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517443200000",
    "number": "1902860356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S WALNUT ST",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744226",
            "telephone_number": "405-743-3760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S WALNUT ST",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744226",
            "telephone_number": "405-743-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "RANDALL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2018-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OK",
            "license": "12754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Mary Williams, C-PRSS
• Shannon J Williams, DDS
• Sidney Dalton Williams Jr., M.D.
• William James Williams
• Steven Willingham, D.PH.
• Alysssa Grace Willison
• Carla E Wilsey, M.D.
• Doug N. Wilsey, MD
• Melissa Kay Wilson-Watts, B.S.
• Emily Erin Wilson

• Urology Physician in Stillwater, OK
• Providers in Stillwater, OK by specialty
• Urology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.