Individual
DR. MARYHELEN HAGGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
104 E BRYAN 74066, SALPULPA, OK 74066
(918) 224-4280
Mailing address
1621 S CARSON AVE, TULSA, OK 74119-4215
(918) 592-1989
(918) 592-1877
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
18583
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100174450A
—
OK
05
—
100174450D
—
OK
Enumeration date
10/05/2006
Last updated
07/08/2010
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