Individual
DR. JOHN BRIAN O'DONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1920 E 3RD ST, BLOOMINGTON, IN 47401-3739
(812) 336-4006
(812) 336-1960
Mailing address
1920 EAST THIRD STREET, BLOOMINGTON, IN 47401-3739
(812) 336-4006
(812) 336-1960
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01043101
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200028330A
—
IN
01
—
P080071221
TRAVELLERS MCR PIN
IN
Enumeration date
03/21/2007
Last updated
12/26/2007
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