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General NPI Number Information
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NPI Number | 1700766920
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Entity Type | Individual
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Provider Name | KAMAL HWAIL PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 510 E MEMORIAL RD STE A4
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City | OKLAHOMA CITY
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State | OK
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Zip | 73114-2218
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Country | US
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Telephone | 405-777-4726
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Fax |
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Provider Business Mailing Address
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Address Line | 8113 NW 153RD ST
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City | EDMOND
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State | OK
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Zip | 73013-9175
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Country | US
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Telephone | 616-826-2945
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | OK
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