Provider Demographics
NPI:1306949805
Name:CULBERTSON, DONALD GREEN (PA)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:GREEN
Last Name:CULBERTSON
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 267
Mailing Address - Street 2:
Mailing Address - City:MARFA
Mailing Address - State:TX
Mailing Address - Zip Code:79843-0267
Mailing Address - Country:US
Mailing Address - Phone:432-729-1800
Mailing Address - Fax:432-729-1806
Practice Address - Street 1:210 S SUMMER ST,
Practice Address - Street 2:
Practice Address - City:MARFA
Practice Address - State:TX
Practice Address - Zip Code:79843-0267
Practice Address - Country:US
Practice Address - Phone:432-729-1800
Practice Address - Fax:432-729-1806
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02637363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical