MEDICARE: DR. RICHARD N DONLON 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	207RA0000X	Adolescent Medicine (Internal Medicine) Physician	MD0000025066	TN
2	208000000X	Pediatrics Physician	25066	TN
3	207P00000X	Emergency Medicine Physician	25066	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285682849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD N DONLON M.D.

Provider Business Mailing Address
First Line	:	4095 AMERICAN WAY
Second Line	:	SUITE 1
City	:	MEMPHIS
State	:	TN
Zip	:	38118-8339
Country	:	US
Telephone Number	:	901-271-9500
Fax Number	:	901-271-9501

Provider Business Practice Location Address
First Line	:	4095 AMERICAN WAY
Second Line	:	SUITE 1
City	:	MEMPHIS
State	:	TN
Zip	:	38118-8339
Country	:	US
Telephone Number	:	901-271-9500
Fax Number	:

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

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	05/11/2023

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Directions to “ DR. RICHARD N DONLON M.D.” Practice Location

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