Individual
GLENN DAVIN HARAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6901 S. YORKTOWN AVE., SUITE C, TULSA, OK 74136
(918) 701-2020
(866) 314-4375
Mailing address
6901 S. YORKTOWN AVE., SUITE C, TULSA, OK 74136
(918) 701-2020
(866) 314-4375
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3263
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100254950B
—
OK
05
—
163667003
—
AR
Enumeration date
09/15/2006
Last updated
01/13/2020
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