Individual
MR. JOHN P ODONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
173 NW ALBRITTON LN, LAKE CITY, FL 32055-4451
(386) 755-4020
Mailing address
8622 133RD LN, LIVE OAK, FL 32060-8837
(386) 208-4084
(386) 752-9143
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3548
FL
Other
Enumeration date
07/28/2005
Last updated
08/15/2007
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