Provider Demographics
NPI:1386977809
Name:HA, DAVID MYONG (ARNP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MYONG
Last Name:HA
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1705 RENAISSANCE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3041
Mailing Address - Country:US
Mailing Address - Phone:405-285-7500
Mailing Address - Fax:405-285-7501
Practice Address - Street 1:1140 SW 104TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2992
Practice Address - Country:US
Practice Address - Phone:405-631-3100
Practice Address - Fax:405-631-3106
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2012-09-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OKR0086238363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner