MEDICARE: DONNA EARNSHAW M.D.

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
1	2084P0800X	Psychiatry Physician	17235	AL

General Provider Information

NPI Number	:	1003139643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA EARNSHAW M.D.

Provider Business Mailing Address
First Line	:	266 WEAVER RD W
Second Line	:
City	:	MOUNT VERNON
State	:	AL
Zip	:	36560-7406
Country	:	US
Telephone Number	:	251-829-6474
Fax Number	:

Provider Business Practice Location Address
First Line	:	266 WEAVER RD W
Second Line	:
City	:	MOUNT VERNON
State	:	AL
Zip	:	36560-7406
Country	:	US
Telephone Number	:	251-829-6474
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2010
Last Update Date	:	03/10/2010

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