Provider Demographics
NPI:1033184007
Name:MCDONALD, ROBERT J JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:MCDONALD
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:3527 W TRUMAN BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-5715
Mailing Address - Country:US
Mailing Address - Phone:573-659-5570
Mailing Address - Fax:573-659-5577
Practice Address - Street 1:3527 W TRUMAN BLVD
Practice Address - Street 2:STE 200
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-5715
Practice Address - Country:US
Practice Address - Phone:573-659-5570
Practice Address - Fax:573-659-5577
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2022-08-17
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Provider Licenses
StateLicense IDTaxonomies
MOMDR1K87207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO206789521Medicaid
MOP00061459OtherRAILROAD MEDICARE
24321OtherBLUE CROSS BLUE SHIELD
MO206789521Medicaid