Individual provider · NPI-1

Dr. William L. Bondurant, MD

Family Medicine · Edmond, OK

NPI number1669447371
StatusActive
Last updated in NPPESApr 21, 2014

Details

NPI
1669447371
Entity type
Individual (NPI-1)
Name
Dr. William L. Bondurant
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Feb 17, 2006
Last updated
Apr 21, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine19073OKYes

Practice location

416 W 15th St
Edmond, OK 73013-3747

Phone 405-471-6611 · Fax 405-471-5858

Mailing address

4401 W Memorial Rd
140
Oklahoma City, OK 73134-1785

Phone 405-752-3162 · Fax 405-936-5211

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