Individual
JOHN L O'DONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3673 SOUTHWESTERN BLVD, ORCHARD PARK, NY 14127-1740
(716) 662-8083
(716) 667-2150
Mailing address
3673 SOUTHWESTERN BLVD, ORCHARD PARK, NY 14127-1740
(716) 662-8083
(716) 667-2150
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
189230
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01414882
—
NY
01
—
0905599
INDEPENDENT HEALTH
—
01
—
5244061
BLUE CROSS & BLUE SHIELD
NY
Enumeration date
03/14/2006
Last updated
09/30/2010
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