Individual
DR. JOHN THORNTON O'DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11215 METRO PKWY STE 1, FORT MYERS, FL 33966-1206
(239) 208-2212
Mailing address
11215 METRO PKWY STE 1, FORT MYERS, FL 33966-1206
(239) 208-2212
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
158850
NY
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
MA059107
NJ
2084P0800X
Psychiatry Physician
Primary
158850
NY
2084P0800X
Psychiatry Physician
MA059107
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6359205
—
NJ
Enumeration date
04/14/2006
Last updated
01/05/2023
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