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NPI Code Detail

MEDICARE: RICHARD DONNELL P.A.

MEDICARE:   RICHARD  DONNELL  P.A.
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
1363A00000XPhysician Assistant2012032941MO

General Provider Information

NPI Number : 1598842585
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD DONNELL P.A.
Provider Business Mailing Address
First Line : 3619 RICHARDSON SQUARE DR
Second Line :
City : ARNOLD
State : MO
Zip : 63010-6022
Country : US
Telephone Number : 314-434-8174
Fax Number : 636-464-6755
Provider Business Practice Location Address
First Line : 3619 RICHARDSON SQUARE DR
Second Line :
City : ARNOLD
State : MO
Zip : 63010-6022
Country : US
Telephone Number : 314-434-8174
Fax Number : 636-464-6755
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 03/15/2017

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Directions to “ RICHARD DONNELL P.A.” Practice Location

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