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NPI Code Detail

MEDICARE: MR. JOHN J MCDONALD CRNA

MEDICARE: MR. JOHN J MCDONALD CRNA
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
1367500000XCertified Registered Nurse AnesthetistC001257AR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2430078846OTHERRR MEDICARE GROUP CK6327

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
35W279OTHERARAR BCBS

General Provider Information

NPI Number : 1518953793
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN J MCDONALD CRNA
Provider Business Mailing Address
First Line : 6119 MIDTOWN AVE
Second Line : SUITE 201
City : LITTLE ROCK
State : AR
Zip : 72205-5313
Country : US
Telephone Number : 501-664-4532
Fax Number : 501-663-4335
Provider Business Practice Location Address
First Line : 300 WERNER ST
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71913-6406
Country : US
Telephone Number : 501-321-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2005
Last Update Date : 10/19/2016

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Directions to “ MR. JOHN J MCDONALD CRNA” Practice Location

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