Individual
DR. HEIDI L HAISLIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1401 W 1ST ST, WEWOKA, OK 74884-5097
(405) 257-3396
(405) 257-6908
Mailing address
100 MCDOUGAL DR, HOLDENVILLE, OK 74848-2822
(405) 379-4200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28183
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200339360A
—
OK
Enumeration date
03/03/2011
Last updated
02/04/2021
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