MEDICARE: HALA AKKARY PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program		OK
2	363A00000X	Physician Assistant	3063	OK

General Provider Information

NPI Number	:	1952965758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALA AKKARY PA-C

Provider Business Mailing Address
First Line	:	6201 N SANTA FE AVE STE 2010
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-7532
Country	:	US
Telephone Number	:	405-272-5555
Fax Number	:	405-272-5517

Provider Business Practice Location Address
First Line	:	6201 N SANTA FE AVE STE 2010
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-7532
Country	:	US
Telephone Number	:	405-272-5555
Fax Number	:	405-272-5517

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2019
Last Update Date	:	11/12/2019

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Directions to “ HALA AKKARY PA-C” Practice Location

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