Provider Demographics
NPI:1891792040
Name:CARNAHAN, DON ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:ALAN
Last Name:CARNAHAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:918-540-7753
Mailing Address - Fax:918-540-7709
Practice Address - Street 1:310 2ND AVE SW
Practice Address - Street 2:STE 106-A
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-6743
Practice Address - Country:US
Practice Address - Phone:918-540-7753
Practice Address - Fax:918-540-7709
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2017-04-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK19510208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200462050RMedicaid
OK100080340AMedicaid
OK200462050RMedicaid
OK900522214Medicare PIN
OK100080340AMedicaid