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Individual

KHALIL HAKIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6202 S LEWIS AVE, TULSA, OK 74136-1099
(918) 279-0885
Mailing address
16629 S 233RD EAST AVE, COWETA, OK 74429-6670
(918) 279-0885

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000000000
OK
Enumeration date
07/12/2012
Last updated
07/12/2012
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