Provider Demographics
NPI:1417592130
Name:HELMER, DONALD RAY JR
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:RAY
Last Name:HELMER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4116 S MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74011-2026
Mailing Address - Country:US
Mailing Address - Phone:918-855-2047
Mailing Address - Fax:
Practice Address - Street 1:4116 S MAPLE AVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74011-2026
Practice Address - Country:US
Practice Address - Phone:918-855-2047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist