Healthcare Provider Details

I. General information

NPI: 1790941730
Provider Name (Legal Business Name): MR. THOMAS JOHN DONLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7628 WINDSOR FOREST PL
HARRISBURG NC
28075-6504
US

IV. Provider business mailing address

7628 WINDSOR FOREST PL
HARRISBURG NC
28075-6504
US

V. Phone/Fax

Practice location:
  • Phone: 704-455-1559
  • Fax:
Mailing address:
  • Phone: 704-455-1559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: