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General NPI Number Information
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NPI Number | 1528071032
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Entity Type | Individual
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Provider Name | DONA RAE DAVIS ARNP
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Gender | Female
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 620 E OKMULGEE
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City | MUSKOGEE
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State | OK
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Zip | 74403
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Country | US
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Telephone | 918-682-1433
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Fax | 918-682-4037
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Provider Business Mailing Address
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Address Line | 2817 ROBIN LANE
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City | MUSKOGEE
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State | OK
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Zip | 74403
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Country | US
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Telephone | 918-683-2180
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Fax | 918-478-3668
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R0027514
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License Number State | OK
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