Provider Demographics
NPI:1811063407
Name:GIVENS, DONNA R (MD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:R
Last Name:GIVENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 HOSPITAL LN
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:WY
Mailing Address - Zip Code:83110-9409
Mailing Address - Country:US
Mailing Address - Phone:307-885-5852
Mailing Address - Fax:
Practice Address - Street 1:110 HOSPITAL LN
Practice Address - Street 2:
Practice Address - City:AFTON
Practice Address - State:WY
Practice Address - Zip Code:83110-9409
Practice Address - Country:US
Practice Address - Phone:078-855-8523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY14768A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine