Provider Demographics
NPI:1962464214
Name:CAUTHEN, DON B (MD)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:B
Last Name:CAUTHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 SW 59TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-8303
Mailing Address - Country:US
Mailing Address - Phone:405-740-1968
Mailing Address - Fax:
Practice Address - Street 1:415 SW 59TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-8303
Practice Address - Country:US
Practice Address - Phone:405-740-1968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD6980207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1165367-03Medicaid
TX080161796OtherRR/MEDICARE
TX1165367-02OtherCSHCN
TX807453OtherBLUE SHIELD
TXB21741Medicare UPIN
TX1165367-02OtherCSHCN