Provider Demographics
NPI:1861898488
Name:WILLIAMS-KUPEC, ZACHARY
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:WILLIAMS-KUPEC
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 1:201 S CREEKDALE DR
Mailing Address - Street 2:1110
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-5047
Mailing Address - Country:US
Mailing Address - Phone:405-343-3030
Mailing Address - Fax:
Practice Address - Street 1:201 S CREEKDALE DR
Practice Address - Street 2:1110
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-5047
Practice Address - Country:US
Practice Address - Phone:405-343-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator