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NPI Code Detail

MEDICARE: BRUCE FLEMING MCDONALD DO

MEDICARE: BRUCE FLEMING MCDONALD DO
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
1207NS0135XProcedural Dermatology PhysicianK9351TX
2207N00000XDermatology PhysicianK9351TX

General Provider Information

NPI Number : 1336143262
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE FLEMING MCDONALD DO
Provider Business Mailing Address
First Line : 4206 CALL FIELD RD
Second Line :
City : WICHITA FALLS
State : TX
Zip : 76308-2519
Country : US
Telephone Number : 940-397-5200
Fax Number :
Provider Business Practice Location Address
First Line : 4206 CALL FIELD RD
Second Line :
City : WICHITA FALLS
State : TX
Zip : 76308-2519
Country : US
Telephone Number : 940-397-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 11/10/2021

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