Provider Demographics
NPI:1275523920
Name:HORTON, DONALD DEE (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:DEE
Last Name:HORTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1403
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-1403
Mailing Address - Country:US
Mailing Address - Phone:405-329-6100
Mailing Address - Fax:405-326-0486
Practice Address - Street 1:14100 PARKWAY COMMONS DR
Practice Address - Street 2:SUITE 201
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-6015
Practice Address - Country:US
Practice Address - Phone:405-242-4720
Practice Address - Fax:405-242-4724
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK14763174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKE73151Medicare UPIN