Provider Demographics
NPI:1114935434
Name:SPADONE, DONALD P (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:P
Last Name:SPADONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DONALD
Other - Middle Name:P
Other - Last Name:SPADONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:608 NW 9TH ST
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-1068
Mailing Address - Country:US
Mailing Address - Phone:405-231-3737
Mailing Address - Fax:405-272-6144
Practice Address - Street 1:608 NW 9TH ST
Practice Address - Street 2:SUITE 2200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1068
Practice Address - Country:US
Practice Address - Phone:405-231-3737
Practice Address - Fax:405-272-6144
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2020-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK283122086S0129X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200328570AMedicaid
MO001014592Medicare ID - Type UnspecifiedMEDICARE
000014592Medicare PIN
MO202916011Medicaid