Provider Demographics
NPI:1912035676
Name:VIETH, DONNA
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:VIETH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 N MAY AVE
Mailing Address - Street 2:STE C
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-6641
Mailing Address - Country:US
Mailing Address - Phone:405-601-0954
Mailing Address - Fax:405-601-3750
Practice Address - Street 1:305 S 5TH
Practice Address - Street 2:ST. MARY'S HOSPITAL
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701
Practice Address - Country:US
Practice Address - Phone:580-233-6100
Practice Address - Fax:580-249-3982
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK60246X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist Cardiovascular