Individual
MARK J MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 E CHESTNUT ST, LOUISVILLE, KY 40202-1831
(502) 629-6000
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
32116
KY
208000000X
Pediatrics Physician
32116
KY
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
32116
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200188960
—
IN
05
—
64321169
—
KY
05
—
T66265
—
SC
Enumeration date
01/25/2006
Last updated
03/26/2024
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