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NPI Code Detail

MEDICARE: DR. RABIYYAH H. HAZZIEZ D.C.

MEDICARE: DR. RABIYYAH H. HAZZIEZ D.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
1111N00000XChiropractor3769OK

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1V09053MEDICARE UPINOK
2239611804MEDICARE PINOK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3431891017OTHEROKHEALTH CHOICE
40155349OTHEROKCIGNA

General Provider Information

NPI Number : 1407866940
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RABIYYAH H. HAZZIEZ D.C.
Provider Business Mailing Address
First Line : 7237 S 92ND EAST AVE APT 6
Second Line :
City : TULSA
State : OK
Zip : 74133-4705
Country : US
Telephone Number : 918-249-8080
Fax Number :
Provider Business Practice Location Address
First Line : 320 N 4TH AVE
Second Line :
City : STROUD
State : OK
Zip : 74079-3641
Country : US
Telephone Number : 918-968-2656
Fax Number : 918-968-2659
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 11/13/2007

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