Provider Demographics
NPI:1992088108
Name:KEYLADA, HANY HESHMAT (MD)
Entity type:Individual
Prefix:DR
First Name:HANY
Middle Name:HESHMAT
Last Name:KEYLADA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4825 S PEORIA AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-4555
Mailing Address - Country:US
Mailing Address - Phone:918-960-7373
Mailing Address - Fax:918-960-9393
Practice Address - Street 1:4825 S PEORIA AVE STE 2
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-4555
Practice Address - Country:US
Practice Address - Phone:918-960-7373
Practice Address - Fax:918-960-9393
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01051816A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine