Provider Demographics
NPI:1528161478
Name:BRANHAM, DONALD LEE (DPH)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:LEE
Last Name:BRANHAM
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28951 MEADOWVIEW DR
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-8744
Mailing Address - Country:US
Mailing Address - Phone:918-567-7012
Mailing Address - Fax:918-567-7037
Practice Address - Street 1:ONE CHOCTAW WAY
Practice Address - Street 2:CHOCTAW NATION HEALTH CENTER
Practice Address - City:TALIHINA
Practice Address - State:OK
Practice Address - Zip Code:74571
Practice Address - Country:US
Practice Address - Phone:918-567-7012
Practice Address - Fax:918-567-7037
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist