Provider Demographics
NPI:1376604488
Name:MCDONALD, CLEMENT JOSEPH III (MD)
Entity Type:Individual
Prefix:
First Name:CLEMENT
Middle Name:JOSEPH
Last Name:MCDONALD
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:9002 N MERIDIAN ST
Mailing Address - Street 2:STE 222
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5381
Mailing Address - Country:US
Mailing Address - Phone:317-819-4516
Mailing Address - Fax:317-819-0044
Practice Address - Street 1:1115 RONALD REAGAN PKWY
Practice Address - Street 2:STE 255
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-6910
Practice Address - Country:US
Practice Address - Phone:317-217-2255
Practice Address - Fax:317-819-0044
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2023-07-24
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Provider Licenses
StateLicense IDTaxonomies
IN01056684A207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology