Provider Demographics
NPI:1548293665
Name:CLYMER, WILLIAM EDWARD (DO)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:EDWARD
Last Name:CLYMER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141N ROBINSON AVE 101A
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-4919
Mailing Address - Country:US
Mailing Address - Phone:405-601-6181
Mailing Address - Fax:405-601-6181
Practice Address - Street 1:557 HARRISON ST
Practice Address - Street 2:
Practice Address - City:PAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74058-2566
Practice Address - Country:US
Practice Address - Phone:918-762-5050
Practice Address - Fax:877-515-8550
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2777207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100089370HMedicaid
E45361Medicare UPIN
E45361Medicare UPIN