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1124067269

NPI Code Detail

MEDICARE: ROBERT JOHN MCDONALD MD

MEDICARE: ROBERT JOHN MCDONALD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207U00000X	Nuclear Medicine Physician	ME0051842	FL
2	2085R0202X	Diagnostic Radiology Physician	ME51842	FL
3	2085N0904X	Nuclear Radiology Physician	ME51842	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10715379	OTHER	FL	CAQH
2	04699	OTHER		BCBS
3	ME51842	OTHER	FL	FLORIDA LICENSE
4	2324753	OTHER		AETNA HMO
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	4388637	OTHER		AETNA PPO

General Provider Information

NPI Number	:	1124067269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT JOHN MCDONALD MD

Provider Business Mailing Address
First Line	:	PO BOX 102222
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30368-2222
Country	:	US
Telephone Number	:	239-432-8500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1281 E COTTONWOOD LN
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-2949
Country	:	US
Telephone Number	:	520-863-9800
Fax Number	:	520-836-1510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	09/25/2025

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Directions to “ ROBERT JOHN MCDONALD MD” Practice Location

Language	Start Address	Practice Location

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