Healthcare Provider Details

I. General information

NPI: 1962464214
Provider Name (Legal Business Name): DON B. CAUTHEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 SW 59TH ST
OKLAHOMA CITY OK
73109-8303
US

IV. Provider business mailing address

415 SW 59TH ST
OKLAHOMA CITY OK
73109-8303
US

V. Phone/Fax

Practice location:
  • Phone: 405-740-1968
  • Fax:
Mailing address:
  • Phone: 405-740-1968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD6980
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: