Provider Demographics
NPI:1053004796
Name:ATKINSON, WILLIAM TATE
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:TATE
Last Name:ATKINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 DRAKESTONE AVE
Mailing Address - Street 2:
Mailing Address - City:NICHOLS HILLS
Mailing Address - State:OK
Mailing Address - Zip Code:73120-4715
Mailing Address - Country:US
Mailing Address - Phone:405-642-0949
Mailing Address - Fax:
Practice Address - Street 1:1819 DRAKESTONE AVE
Practice Address - Street 2:
Practice Address - City:NICHOLS HILLS
Practice Address - State:OK
Practice Address - Zip Code:73120-4715
Practice Address - Country:US
Practice Address - Phone:405-642-0949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program