Provider Demographics
NPI:1265527345
Name:QUINTANA, DORIS A (MD)
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:A
Last Name:QUINTANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5555
Mailing Address - Country:US
Mailing Address - Phone:405-936-1180
Mailing Address - Fax:405-751-2960
Practice Address - Street 1:10900 HEFNER POINTE DR STE 505
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120
Practice Address - Country:US
Practice Address - Phone:405-936-1180
Practice Address - Fax:405-751-2960
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK18475208600000X
VA0101254143208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F83391Medicare UPIN