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Organization
JAMES E MCDONNELL MD PLC
Active
Organization
JAMES E MCDONNELL MD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES EDWARD MCDONNELL M.D. (OWNER/PHYSICIAN/PRESIDENT)
(386) 677-6727
Entity
Organization
Contact information
Practice address
305 CLYDE MORRIS BLVD, SUITE 130, ORMOND BEACH, FL 32174-8181
(386) 677-6727
(386) 677-3211
Mailing address
305 CLYDE MORRIS BLVD, SUITE 130, ORMOND BEACH, FL 32174-8181
(386) 677-6727
(386) 677-3211
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0058254
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14223
BLUE SHIELD
FL
01
—
DE7297
RAILROAD MEDICARE
FL
Enumeration date
09/12/2006
Last updated
08/22/2020
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