Individual
JEFFREY LAYNE MCDONALD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CP
Contact information
Practice address
1142 SHIPYARD BLVD, WILMINGTON, NC 28412-6439
(910) 350-0067
(910) 350-0065
Mailing address
1142 SHIPYARD BLVD, WILMINGTON, NC 28412-6439
(910) 350-0067
(910) 350-0065
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7703733
—
NC
Enumeration date
11/08/2005
Last updated
07/09/2007
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