DONNA J KRUTKA (NPI# 1033216791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033216791 |
| Entity Type | Individual |
| Full Name | DONNA J KRUTKA |
| Credential | M.D. |
| Practice Address |
1919 S Wheeling Ave Suite 304 Tulsa OK 74104-5638 |
| Mailing Address |
1919 S. Wheeling Avenue Suite #304 Tulsa OK 74104 |
| Practice Telephone | 9187487620 |
| Practice Fax Number | 9187487647 |
| Mailing Telephone | 9187496782 |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2011-01-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
13334 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
1919 S WHEELING AVE SUITE 304 |
| City | TULSA |
| State | OK |
| Zip Code | 74104-5638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942293097 | Michael S Charles | Surgery | 1919 S Wheeling Ave, Ste 606, Tulsa, OK 74104-5635 | 2005-08-24 |
| 1710540737 | Lacie Danielle Whinery | Student in an Organized Health Care Education/Training Program | 1919 S Wheeling Ave, Tulsa, OK 74104-5638 | 2019-04-16 |
| 1699134890 | Allyson Michelle Campbell | Physician Assistant | 1919 S Wheeling Ave, Suite 404, Tulsa, OK 74104-5638 | 2016-02-16 |
| 1205200789 | Aerial Chanel Anthony | Physician Assistant | 1919 S Wheeling Ave, Suite 200, Tulsa, OK 74104-5638 | 2015-11-19 |
| 1285018713 | Ob Gyn Specialists of Tulsa Pllc | Obstetrics & Gynecology | 1919 S Wheeling Ave, Ste. 700, Tulsa, OK 74104-5638 | 2015-07-14 |
| 1083025159 | Osu Center for Health Sciences | Clinic/Center | 1919 S Wheeling Ave, Suite 302, Tulsa, OK 74104-5638 | 2014-05-12 |
| 1548688757 | Robert Wittrock | Pediatrics | 1919 S Wheeling Ave, Ste 304, Tulsa, OK 74104-5632 | 2014-04-03 |
| 1235477613 | Alexandros Mallios | Surgery | 1919 S Wheeling Ave, Suite 600, Tulsa, OK 74104-5638 | 2013-01-20 |
| 1841537859 | Jenny Marie Birks | Physician Assistant | 1919 S Wheeling Ave, Suite 402, Tulsa, OK 74104-5638 | 2013-01-10 |
| 1578836201 | Gajal Kumar | Surgery | 1919 S Wheeling Ave, Ste 606, Tulsa, OK 74104-5638 | 2012-02-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982253811 | Ultimate Health and Pain Management | Pain Medicine | 1844 East 15th Street, Tulsa, OK 74104 | 2019-09-04 |
| 1225691223 | David Murray | Student in an Organized Health Care Education/Training Program | 2100 S Wheeling Ave, Tulsa, OK 74104 | 2019-04-16 |
| 1083115828 | Susan Fortner | Counselor | 1328 S. Delaware Pl, Tulsa, OK 74104 | 2018-02-27 |
| 1033636915 | Mark Brizendine | Dietitian, Registered | Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 | 2017-08-23 |
| 1295259067 | Demi Reyd Cook | Nurse Practitioner | 1717 A South Utica, Tulsa, OK 74104 | 2017-08-02 |
| 1851827059 | Oklahoma Cvs Pharmacy | Durable Medical Equipment & Medical Supplies | 1701 E 15th Street, Tulsa, OK 74104 | 2017-05-08 |
| 1801334982 | Jamie Lynne Miller | Internal Medicine | 2000 S. Wheeling Avenue Ste 510, Tulsa, OK 74104 | 2017-02-08 |
| 1578913430 | Donna Durant-macon | Registered Nurse | 315 South Utica, Tulsa, OK 74104 | 2016-06-21 |
| 1669833851 | Mbc Dental | Dentist | 401 S. Utica Ave, #a, Tulsa, OK 74104 | 2016-03-15 |
| 1518332170 | Neuro Dynamics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 22 S Lewis, Tulsa, OK 74104 | 2015-12-08 |
| Find all providers in zip 74104 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356544951 | Kristin Diane Conkling | Pediatrics | 5125 E 107th Pl, Tulsa, OK 74137-7236 | 2007-06-09 |
| 1780789362 | Children & Adolescent Medical Services Inc. | Pediatrics | 8803 S. 101st E. Ave., Suite 200, Tulsa, OK 74133 | 2006-09-14 |
| 1922038348 | Paul Andrew Scott Benson | Pediatrics | 4444 E. 41st Street, 2nd Floor, Ou Physicians -- Pediatrics, Tulsa, OK 74135 | 2006-07-03 |
| 1285891945 | Kids Pediatric and Adolescent Care | Pediatrics | 7711 E 111th St, Suite 111, Tulsa, OK 74133-2570 | 2008-05-20 |
| 1073641395 | Lamiaa Hassan Ali | Pediatrics | 4444 E 41st St, 2nd Floor, Ste A, Tulsa, OK 74135-2527 | 2007-02-28 |
| 1144327800 | Hugh C Graham | Pediatrics | 1919 S Wheeling Ave, Suite 304, Tulsa, OK 74104-5638 | 2006-09-17 |
| 1770680423 | Joel K Gist | Pediatrics | 1919 S Wheeling Ave, Suite 304, Tulsa, OK 74104-5638 | 2006-09-17 |
| 1306800362 | Scott Samuel Cyrus | Pediatrics | 8803 S 101st East Ave, Ste 200, Tulsa, OK 74133-5726 | 2006-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770504037 | Miguel Antonio Camacho-garrido | Pediatrics | 1104 Walnut Dr, Ardmore, OK 73401-2353 | 2006-07-22 |
| 1497788624 | Shelley Ann Bohn | Pediatrics | 937 Sw 89th St, Suite A, Oklahoma City, OK 73139-9231 | 2006-07-09 |
| 1235128430 | Elizabeth Gail Lewis | Pediatrics | 2701 Sw Cornell Ave, Lawton, OK 73505-7121 | 2005-10-19 |
| 1871581470 | Charles R Mettry | Pediatrics | 201 N Monte Vista St, Suite B, Ada, OK 74820-7200 | 2005-10-10 |
| 1578568010 | Julie Gail Sullivan | Pediatrics | 1615 S Eucalyptus Ave, Suite 210, Broken Arrow, OK 74012-6159 | 2005-06-20 |
| 1902446917 | Chelsea Ryan Walker | Pediatrics | 12455 E 100th St N Ste 300, Owasso, OK 74055-4678 | 2020-01-08 |
| 1609005842 | Ahmad Pediatrics | Pediatrics | 302 E Downing St, Tahlequah, OK 74464-3014 | 2009-07-09 |
| 1235399122 | South Pointe Pediatrics, Pllc | Pediatrics | 1615 S Eucalyptus Ave, Suite 210, Broken Arrow, OK 74012-6159 | 2008-06-13 |
| 1235207515 | Southwest Pediatrics, Pllc | Pediatrics | 937 Sw 89th St, Suite A, Oklahoma City, OK 73139-9231 | 2006-12-02 |
| 1053486431 | Northern Oklahoma Regional Pediatric Clinic, Pllc | Pediatrics | 415 Fairview Ave, Ste. 100, Ponca City, OK 74601-1923 | 2006-11-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.