Healthcare Provider Details

I. General information

NPI: 1033104898
Provider Name (Legal Business Name): KAREN A HEUPEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 02/21/2020
Certification Date: 02/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FEDERAL AVIATION ADMINISTRATION AAM-700 BLDG 13
OKLAHOMA CITY OK
73169
US

IV. Provider business mailing address

6400 RAMBRIDGE DR
OKLAHOMA CITY OK
73162-1728
US

V. Phone/Fax

Practice location:
  • Phone: 405-954-1000
  • Fax:
Mailing address:
  • Phone: 334-224-0349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberG080761
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: