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General NPI Number Information
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NPI Number | 1821365370
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Entity Type | Organization
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Legal Business Name | JOHN L O'DONNELL MD PC
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Dates
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Enumeration Date | 11/29/2011
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Last Update Date | 11/29/2011
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Provider Practice Location Address
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Address Line | 3673 SOUTHWESTERN BLVD
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City | ORCHARD PARK
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State | NY
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Zip | 14127-1740
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Country | US
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Telephone | 716-662-8083
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Fax | 716-667-2150
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Provider Business Mailing Address
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Address Line | 3673 SOUTHWESTERN BLVD
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City | ORCHARD PARK
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State | NY
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Zip | 14127-1740
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Country | US
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Telephone | 716-662-8083
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Fax | 716-667-2150
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MAUREEN FINNEGAN
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Credential |
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Telephone | 716-662-8083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 189230
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License Number State | NY
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