Provider Demographics
NPI:1477812436
Name:BEECHUM, DONNY RAY SR (MSM, BHRS)
Entity Type:Individual
Prefix:MR
First Name:DONNY
Middle Name:RAY
Last Name:BEECHUM
Suffix:SR
Gender:M
Credentials:MSM, BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5816 S VENTURA DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73135-5473
Mailing Address - Country:US
Mailing Address - Phone:405-733-7810
Mailing Address - Fax:
Practice Address - Street 1:5929 N MAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-3909
Practice Address - Country:US
Practice Address - Phone:405-570-0639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst