Provider Demographics
NPI:1568523165
Name:DUSHAY, DONALD M (DO)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:M
Last Name:DUSHAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4444 S HARVARD AVE
Mailing Address - Street 2:#100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2634
Mailing Address - Country:US
Mailing Address - Phone:918-744-0228
Mailing Address - Fax:918-744-6613
Practice Address - Street 1:4444 S HARVARD AVE
Practice Address - Street 2:#100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2634
Practice Address - Country:US
Practice Address - Phone:918-744-0228
Practice Address - Fax:918-744-6613
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK1135207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C94582Medicare UPIN