Healthcare Provider Details

I. General information

NPI: 1558301481
Provider Name (Legal Business Name): JOHN M. MCDONALD JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17925 US HWY 431 SOUTH
HEADLAND AL
36345
US

IV. Provider business mailing address

PO BOX 312
HEADLAND AL
36345-0312
US

V. Phone/Fax

Practice location:
  • Phone: 334-944-2490
  • Fax:
Mailing address:
  • Phone: 344-232-2733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number00025924
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.25924
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: