Provider Demographics
NPI:1033216791
Name:KRUTKA, DONNA J (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:J
Last Name:KRUTKA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1919 S. WHEELING AVENUE
Mailing Address - Street 2:SUITE #304
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104
Mailing Address - Country:US
Mailing Address - Phone:918-749-6782
Mailing Address - Fax:
Practice Address - Street 1:1919 S WHEELING AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5638
Practice Address - Country:US
Practice Address - Phone:918-748-7620
Practice Address - Fax:918-748-7647
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2011-01-13
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Provider Licenses
StateLicense IDTaxonomies
OK133342080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine