Provider Demographics
NPI:1073679775
Name:OKLAHOMA HAND SURGERY CENTER, INC.
Entity Type:Organization
Organization Name:OKLAHOMA HAND SURGERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:HIEKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-748-6600
Mailing Address - Street 1:10914 HEFNER POINTE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-5066
Mailing Address - Country:US
Mailing Address - Phone:405-748-6600
Mailing Address - Fax:405-748-6472
Practice Address - Street 1:10914 HEFNER POINTE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-5066
Practice Address - Country:US
Practice Address - Phone:405-748-6600
Practice Address - Fax:405-748-6472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK011885641207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========Medicare ID - Type UnspecifiedGROUP ID