Individual
JACQUELINE A O'DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1801 N SENATE BLVD, INDIANAPOLIS, IN 46202-1228
(317) 962-0560
Mailing address
PO BOX 44994, INDIANAPOLIS, IN 46244-0994
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01026329
IN
207RC0001X
Clinical Cardiac Electrophysiology Physician
01026329A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
01026329A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060066278
RAILROAD MEDICARE
IN
05
—
100065910
—
IN
Enumeration date
04/18/2006
Last updated
04/20/2011
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