Individual
MR. IRVIN CORDELL MCDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
(601) 368-3917
Mailing address
288 PARKS RD, JACKSON, MS 39212-9601
(601) 362-4471
(601) 368-3917
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
R588806
MS
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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