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Individual

DR. JAY PAUL MCDONALD II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7900 AIRWAYS BLVD STE 2, SOUTHAVEN, MS 38671-4113
(662) 404-8630
Mailing address
PO BOX 649113, DALLAS, TX 75264-9113
(855) 343-5763
(855) 343-5763

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
23317
MS
207L00000X
Anesthesiology Physician
56365
TN
207LP2900X
Pain Medicine (Anesthesiology) Physician
23317
MS
208VP0014X
Interventional Pain Medicine Physician
23317
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01522869
MS
05
100181198
MS
05
Q031256
TN
Enumeration date
07/06/2010
Last updated
06/25/2025
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