Organization
DONEY MEDICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK R. DONEY M.D. (PHYSICIAN)
(918) 542-8477
Entity
Organization
Contact information
Practice address
310 2ND AVE SW, SUITE 201, MIAMI, OK 74354-6702
(918) 542-8477
(918) 542-6422
Mailing address
310 2ND AVE SW, SUITE 201, MIAMI, OK 74354-6702
(918) 542-8477
(918) 542-6422
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11653
OK
207V00000X
Obstetrics & Gynecology Physician
11653
OK
261QM2500X
Medical Specialty Clinic/Center
Primary
11653
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100209450A
—
OK
05
—
100735640A
—
OK
Enumeration date
10/24/2006
Last updated
04/11/2023
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