Provider Demographics
NPI:1225067051
Name:MCDONALD, DANIEL KIRK (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:KIRK
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 1:1800 BIRMINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-5461
Mailing Address - Country:US
Mailing Address - Phone:205-384-4585
Mailing Address - Fax:205-384-4428
Practice Address - Street 1:1800 BIRMINGHAM AVE
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-5461
Practice Address - Country:US
Practice Address - Phone:205-384-4585
Practice Address - Fax:205-384-4428
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21930207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALH13447Medicare UPIN