MEDICARE: DR. PAUL D MAITINO D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	3588	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	200038126	OTHER	OK	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376507665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL D MAITINO D.O.

Provider Business Mailing Address
First Line	:	PO BOX 108809
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73101-8809
Country	:	US
Telephone Number	:	405-419-8444
Fax Number	:	405-419-7797

Provider Business Practice Location Address
First Line	:	3110 SW 89TH ST
Second Line	:	STE 200 D
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-7920
Country	:	US
Telephone Number	:	405-735-6270
Fax Number	:	405-680-4160

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	01/30/2013

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Directions to “ DR. PAUL D MAITINO D.O.” Practice Location

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