Provider Demographics
NPI:1164915724
Name:MCDONALD, COLIN ARTHUR (MD)
Entity Type:Individual
Prefix:
First Name:COLIN
Middle Name:ARTHUR
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HOSPITAL DR # DC032.00
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65212-1000
Mailing Address - Country:US
Mailing Address - Phone:573-214-2314
Mailing Address - Fax:573-814-2784
Practice Address - Street 1:1 HOSPITAL DR # DC032.00
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-1000
Practice Address - Country:US
Practice Address - Phone:573-214-2314
Practice Address - Fax:573-814-2784
Is Sole Proprietor?:No
Enumeration Date:2018-06-08
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021009094207Q00000X
MO2018018745207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine