Provider Demographics
NPI:1376507665
Name:MAITINO, PAUL D (DO)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:D
Last Name:MAITINO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 108809
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73101-8809
Mailing Address - Country:US
Mailing Address - Phone:405-419-8444
Mailing Address - Fax:405-419-7797
Practice Address - Street 1:3110 SW 89TH ST
Practice Address - Street 2:STE 200 D
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7920
Practice Address - Country:US
Practice Address - Phone:405-735-6270
Practice Address - Fax:405-680-4160
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2013-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK3588207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200038126OtherMEDICARE RAILROAD
OK100001220AMedicaid
OKG11200Medicare UPIN
OK100001220AMedicaid