Individual
DR. KELLY M. W. MCDONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
700 S PARK ST, MADISON, WI 53715-1830
(608) 260-2900
(608) 260-2956
Mailing address
700 S PARK ST, MADISON, WI 53715-1830
(608) 260-2900
(608) 260-2956
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
62406
WI
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
62406-21
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871705111
—
WI
Enumeration date
05/07/2007
Last updated
12/11/2020
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