Individual
DR. DOUGLAS ALAN DONNELLY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
424 N WASHINGTON AVE, IOLA, KS 66749-2353
(620) 365-2108
(620) 365-2522
Mailing address
PO BOX 847, 424 N WASHINGTON, IOLA, KS 66749-0847
(620) 365-2108
(620) 365-2522
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1277
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100218530B
—
KS
01
—
658080
FIRSTGUARD
KS
01
—
P00094712
RAILROAD MEDICARE
KS
Enumeration date
02/21/2006
Last updated
07/08/2007
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