Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 16828 | OK |
NPI | 1588660898 |
---|---|
Provider Name | Dr. Kenneth A. Hieke |
First Address | Oklahoma City, OK 73134-1785 |
Second Address | Oklahoma City, OK 73120-5069 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 20/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E28927 | (02) | OK |