Provider Demographics
NPI:1619071164
Name:PRICE, DONNA J (DO)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:J
Last Name:PRICE
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:PO BOX 969
Mailing Address - Street 2:159 W. 146TH ST
Mailing Address - City:GLENPOOL
Mailing Address - State:OK
Mailing Address - Zip Code:74033-0969
Mailing Address - Country:US
Mailing Address - Phone:918-322-3838
Mailing Address - Fax:918-322-3827
Practice Address - Street 1:159 W. 146TH ST
Practice Address - Street 2:STE 4
Practice Address - City:GLENPOOL
Practice Address - State:OK
Practice Address - Zip Code:74033
Practice Address - Country:US
Practice Address - Phone:918-322-3838
Practice Address - Fax:918-322-3827
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-10-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK3877207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKH71020Medicare UPIN