Waters, Edwin C
Waters, Edwin C is an individual health care provider with primary practice located at 12455 E 100Th St N Suite 120, Owasso OK 74055-4674. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Waters, Edwin C can be contacted via phone (918) 274-5510.Contact Information
Primary practice address
12455 E 100Th St N Suite 120
Owasso OK 74055-4674
Phone: (918) 274-5510
Fax: (918) 274-5519
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 115331 | Missouri |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 25302 | Oklahoma |
Profile Details
| NPI number | 1861439507 |
|---|---|
| LBN Legal business name | Waters, Edwin C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2006 |
| Last updated | Feb 9th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861439507 | NPPES |
| Missouri | MEDICAID | 205336308 |
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