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Individual
MICHAEL WAYNE HAFNER
Active
Individual
MICHAEL WAYNE HAFNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1771
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1771
STATE LICENSE
OK
05
—
200219760A
—
OK
Enumeration date
09/10/2008
Last updated
01/30/2009
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