Provider Demographics
NPI:1952353427
Name:HABJ-BIK, YNAL (MD)
Entity Type:Individual
Prefix:
First Name:YNAL
Middle Name:
Last Name:HABJ-BIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 W MEMORIAL RD
Mailing Address - Street 2:OKLAHOMA CITY
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1785
Mailing Address - Country:US
Mailing Address - Phone:405-752-3162
Mailing Address - Fax:405-936-5211
Practice Address - Street 1:1152 US HIGHWAY 70A
Practice Address - Street 2:WILSON
Practice Address - City:WILSON
Practice Address - State:OK
Practice Address - Zip Code:73463-1482
Practice Address - Country:US
Practice Address - Phone:580-668-2882
Practice Address - Fax:580-668-2772
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20914207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK458688397002OtherBCBS 12 DIGIT #
OK20914OtherOK LICENSE
OK458688397002OtherBCBS 12 DIGIT #
OK100019590DMedicaid
OK100230620AOtherSOONERCARE ID #
OKG85228Medicare UPIN