| Quyen Ha Md Pc | |
|
430 N Monte Vista St Valley View Reg Hospital Wound Care Center Ada OK 74820-4610 | |
| (580) 272-1731 | |
| (580) 272-1720 |
| Full Name | Quyen Ha Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 430 N Monte Vista St, Ada, Oklahoma |
| Authorized Official Name and Position | Quyen Thanh Ha (CEO) |
| Authorized Official Contact | 5127999068 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Quyen Ha Md Pc Po Box 12883 Oklahoma City OK 73157-2883 Ph: (405) 858-0600 | Quyen Ha Md Pc 430 N Monte Vista St Valley View Reg Hospital Wound Care Center Ada OK 74820-4610 Ph: (580) 272-1731 |
| NPI Number | 1205063658 |
|---|---|
| Provider Enumeration Date | 06/12/2009 |
| Last Update Date | 02/14/2011 |
| Medicare PECOS PAC ID | 1153473400 |
|---|---|
| Medicare Enrollment ID | O20090716000536 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205063658 | NPI | - | NPPES |
| 200247790A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 24063 (Oklahoma) | Primary |
| Provider Name | Quyen T Ha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245383264 PECOS PAC ID: 7517068513 Enrollment ID: I20070720000352 |
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