# DAVID R DONALDSON M.D., PLLC

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

## Provider details

- **NPI number:** 1689869836
- **Authorized official:** MRS. DEBBY WILCOX (MANAGER)
- **Authorized official phone:** (208) 232-2146

## Contact information

- **Practice address:** 333 N 18TH AVE, ST\#B3, POCATELLO, ID 83201
- **Practice address phone:** (208) 232-2146
- **Practice address fax:** (208) 232-2770
- **Mailing address:** 333 N 18TH AVE, ST\#B3, POCATELLO, ID 83201-3358
- **Mailing address phone:** (208) 232-2146
- **Mailing address fax:** (208) 232-2770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | M9470 | ID | Yes |

## Other

- **Enumeration date:** 09/11/2007
- **Last updated:** 07/05/2018