Individual
DR. ROBERT J MCDONALD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3527 W TRUMAN BLVD, STE 200, JEFFERSON CITY, MO 65109-5715
(573) 659-5570
(573) 659-5577
Mailing address
3527 W TRUMAN BLVD, STE 200, JEFFERSON CITY, MO 65109-5715
(573) 659-5570
(573) 659-5577
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MDR1K87
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206789521
—
MO
01
—
24321
BLUE CROSS BLUE SHIELD
—
01
—
P00061459
RAILROAD MEDICARE
MO
Enumeration date
02/22/2006
Last updated
08/17/2022
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