Individual
DONALD L SUTMILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
119 W MAIN ST, HOMINY, OK 74035-1031
(918) 885-4640
(918) 885-4644
Mailing address
212 N MAIN ST, FAIRFAX, OK 74637-3023
(918) 642-3100
(918) 642-5639
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
2274
OK
208D00000X
General Practice Physician
Primary
2274
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100135850A
—
OK
Enumeration date
12/06/2005
Last updated
12/28/2017
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