# TIMOTHY J DONOVAN MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679815294
- **Authorized official:** DR. TIMOTHY JOSPEH DONOVAN MD (OWNER/PYSICIAN)
- **Authorized official phone:** (337) 239-2600

## Contact information

- **Practice address:** 103 WEST UNIVERSITY PARKWAY, LEESVILLE, LA 71446-4482
- **Practice address phone:** (337) 239-2600
- **Practice address fax:** (337) 239-2601
- **Mailing address:** 103 WEST UNIVERSITY PARKWAY, LEESVILLE, LA 71446-4482
- **Mailing address phone:** (337) 239-2600
- **Mailing address fax:** (337) 239-2601

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD203745 | LA | Yes |

## Other

- **Enumeration date:** 03/21/2013
- **Last updated:** 10/25/2016