Mr. Irvin Cordell Mcdonald
Nurse Practitioner - Primary Care
1500 E Woodrow Wilson Ave
Jackson
, Mississippi 39216-5116
Mr. Irvin Cordell Mcdonald
Nurse Practitioner - Primary Care
1500 E Woodrow Wilson Ave
Jackson
, Mississippi 39216-5116
(601) 368-3917
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About
Features
Specialties
- Nurse Practitioner - Primary Care
Languages spoken
- English
Location
First Address
- Mr. Irvin Cordell Mcdonald
- 288 Parks Rd
- Jackson, MS
- Zip : 39212-9601
- Fax : (601) 368-3917
- Phone : (601) 362-4471
Second Address
- Mr. Irvin Cordell Mcdonald
- 1500 E Woodrow Wilson Ave
- Jackson, MS
- Zip : 39216-5116
- Fax : (601) 368-3917
- Phone : (601) 362-4471
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Is Mr. Irvin Cordell Mcdonald a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP2300X | Nurse Practitioner - Primary Care | R588806 | MS |
National Provider Identifier
| NPI | 1023025319 |
|---|---|
| Provider Name | Mr. Irvin Cordell Mcdonald |
| First Address | Jackson, MS 39212-9601 |
| Second Address | Jackson, MS 39216-5116 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/08/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.