Provider Demographics
NPI:1275712010
Name:STINNETT, DONOVAN MITCHELL (MD)
Entity Type:Individual
Prefix:
First Name:DONOVAN
Middle Name:MITCHELL
Last Name:STINNETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1701 W 26TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-1513
Mailing Address - Country:US
Mailing Address - Phone:417-625-2802
Mailing Address - Fax:417-782-6750
Practice Address - Street 1:1701 W 26TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-1513
Practice Address - Country:US
Practice Address - Phone:417-625-2802
Practice Address - Fax:417-782-6750
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR2B24208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)