Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1-114040 | AL |
N | 363LA2100X | Nurse Practitioner - Acute Care | 9296521 | FL |
NPI | 1023420809 |
---|---|
Provider Name | Mr. Paul Mcdonald |
First Address | Panama City, FL 32401-2727 |
Second Address | Gardendale, AL 35071 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2014 |
Last Update Date | 12/07/2018 |