MEDICARE: DR. DEVIN SCOTT HIROKI MCDONALD DPT

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	225100000X	Physical Therapist	5974	OK

General Provider Information

NPI Number	:	1437725397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEVIN SCOTT HIROKI MCDONALD DPT

Provider Business Mailing Address
First Line	:	318 NW 27TH ST UNIT 1
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73103-3009
Country	:	US
Telephone Number	:	918-944-9708
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 N BROADWAY AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73103-4609
Country	:	US
Telephone Number	:	918-944-9708
Fax Number	:

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

Provider Enumeration Date	:	06/01/2021
Last Update Date	:	06/01/2021

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