Provider Demographics
NPI:1205842911
Name:MCDONNELL, MAURICE FRANCIS JR (RCP CRT)
Entity Type:Individual
Prefix:MR
First Name:MAURICE
Middle Name:FRANCIS
Last Name:MCDONNELL
Suffix:JR
Gender:M
Credentials:RCP CRT
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Mailing Address - Street 1:912 GAINESVILLE HWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518
Mailing Address - Country:US
Mailing Address - Phone:678-714-0502
Mailing Address - Fax:770-932-0802
Practice Address - Street 1:912 GAINESVILLE HWY
Practice Address - Street 2:SUITE C
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518
Practice Address - Country:US
Practice Address - Phone:678-714-0502
Practice Address - Fax:770-932-0802
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00948703AMedicaid
GA00948703AMedicaid