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General NPI Number Information
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NPI Number | 1902434830
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Entity Type | Individual
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Provider Name | DEIRDRE CATHERINA MCDONNELL MD
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Gender | Female
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 1101 PROFESSIONAL BLVD
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City | EVANSVILLE
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State | IN
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Zip | 47714-8016
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Country | US
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Telephone | 812-477-7246
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Fax | 270-554-8987
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Provider Business Mailing Address
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Address Line | 1101 PROFESSIONAL BLVD
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City | EVANSVILLE
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State | IN
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Zip | 47714-8016
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Country | US
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Telephone | 812-477-7246
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Fax | 270-554-8987
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 12160
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 01091149A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 58408
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01091149A
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License Number State | IN
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