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Individual

MR. DONALD A DESALVO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
3500 E FRANK PHILLIPS BLVD, BARTLESVILLE, OK 74006-2411
(918) 331-1555
(918) 333-1695
Mailing address
PO BOX 3456, BARTLESVILLE, OK 74006-3456
(918) 333-4100
(918) 333-4106

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
680876
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
R 88186
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010672601002
BCBSOK
OK
05
200086500A
OK
05
20086500A
OK
Enumeration date
07/08/2006
Last updated
10/13/2011
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