Basic Information
Provider Information
NPI: 1396908752
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROBBINS
FirstName: HAL
MiddleName: HAYLOR
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 802 S JACKSON AVE STE 505
Address2:  
City: TULSA
State: OK
PostalCode: 741279060
CountryCode: US
TelephoneNumber: 9187475322
FaxNumber: 9187467604
Practice Location
Address1: 802 S JACKSON AVE STE 505
Address2:  
City: TULSA
State: OK
PostalCode: 741279060
CountryCode: US
TelephoneNumber: 9187475322
FaxNumber: 9187467604
Other Information
ProviderEnumerationDate: 07/07/2008
LastUpdateDate: 02/12/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X4680OKY Allopathic & Osteopathic PhysiciansSurgery 

ID Information
IDTypeStateIssuerDescription
200203930B05OK MEDICAID
OKA10418801OKMEDICAREOTHER


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