Provider Demographics
NPI:1356339816
Name:DURICK, WILLIAM J (M D)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:DURICK
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Gender:M
Credentials:M D
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Mailing Address - Street 1:1501 N FLORENCE
Mailing Address - Street 2:STE 101
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-3169
Mailing Address - Country:US
Mailing Address - Phone:918-342-3633
Mailing Address - Fax:918-342-8959
Practice Address - Street 1:1501 N FLORENCE
Practice Address - Street 2:STE 101
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-3169
Practice Address - Country:US
Practice Address - Phone:918-342-3633
Practice Address - Fax:918-342-8959
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2013-03-22
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Provider Licenses
StateLicense IDTaxonomies
OK8542207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100173140AMedicaid
OK100173140AMedicaid
OKC94879Medicare UPIN