Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 28312 | OK |
NPI | 1114935434 |
---|---|
Provider Name | Dr. Donald P Spadone |
First Address | Oklahoma City, OK 73102-1068 |
Second Address | Oklahoma City, OK 73102-1068 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 18/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200328570A | (05) | OK |