Provider Demographics
NPI:1437185667
Name:KLINGER, DONALD (DO)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:KLINGER
Suffix:
Gender:M
Credentials:DO
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 548
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:OK
Mailing Address - Zip Code:73737-0548
Mailing Address - Country:US
Mailing Address - Phone:580-227-2585
Mailing Address - Fax:580-227-2882
Practice Address - Street 1:519 E STATE RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:OK
Practice Address - Zip Code:73737-1458
Practice Address - Country:US
Practice Address - Phone:580-227-2585
Practice Address - Fax:580-227-2882
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4357207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200072450AMedicaid
248603401Medicare PIN
H24470Medicare UPIN
P00306278Medicare PIN