Provider Demographics
NPI:1437725397
Name:MCDONALD, DEVIN SCOTT HIROKI (DPT)
Entity type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:SCOTT HIROKI
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 NW 27TH ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-3009
Mailing Address - Country:US
Mailing Address - Phone:918-944-9708
Mailing Address - Fax:
Practice Address - Street 1:1501 N BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-4609
Practice Address - Country:US
Practice Address - Phone:918-944-9708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5974225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist