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NPI Code Detail

MEDICARE: JEFFREY P DONNELLY PA-C

MEDICARE: JEFFREY P DONNELLY PA-C
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 Assistant060VI

General Provider Information

NPI Number : 1881620623
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY P DONNELLY PA-C
Provider Business Mailing Address
First Line : PO BOX 24863
Second Line :
City : CHRISTIANSTED
State : VI
Zip : 00824-0863
Country : US
Telephone Number : 340-642-5460
Fax Number :
Provider Business Practice Location Address
First Line : 516 STRAND ST
Second Line : FREDERIKSTED HEALTH CENTER
City : FREDERIKSTED
State : VI
Zip : 00840-3533
Country : US
Telephone Number : 340-772-0260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 02/03/2017

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Directions to “ JEFFREY P DONNELLY PA-C” Practice Location

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