Provider Demographics
NPI:1497042170
Name:BUELL, DONALD GENE (CPRSS)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:GENE
Last Name:BUELL
Suffix:
Gender:M
Credentials:CPRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 SW 101ST ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-2942
Mailing Address - Country:US
Mailing Address - Phone:405-863-2201
Mailing Address - Fax:
Practice Address - Street 1:1105 SW 101ST ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2942
Practice Address - Country:US
Practice Address - Phone:405-863-2201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator