Provider Demographics
NPI:1932945540
Name:HAYGARTH, MILES (DPT)
Entity type:Individual
Prefix:
First Name:MILES
Middle Name:
Last Name:HAYGARTH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2935 E 94TH CT APT 818
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-8722
Mailing Address - Country:US
Mailing Address - Phone:214-755-8236
Mailing Address - Fax:
Practice Address - Street 1:6802 S OLYMPIA AVE STE 175
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74132-1804
Practice Address - Country:US
Practice Address - Phone:918-488-2280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6505225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist