Individual
MR. JERRY LAVELL MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPSGT, RST
Contact information
Practice address
2400 HOSPITAL RD, TUSKEGEE, AL 36083-5002
(334) 727-0550
Mailing address
165 BRISCO ST, MADISON, MS 39110-4602
(601) 519-1935
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
12/12/2020
Last updated
12/12/2020
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