Individual
DR. DUSTIN O'LEATH HAYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
817 S ELM PL, SUITE C, BROKEN ARROW, OK 74012-5369
(918) 940-4734
(918) 940-4737
Mailing address
817 S ELM PL, SUITE C, BROKEN ARROW, OK 74012-5369
(918) 940-4734
(918) 940-4737
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
5382
OK
208D00000X
General Practice Physician
5382
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200498030A
—
OK
Enumeration date
04/16/2012
Last updated
01/24/2024
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