Provider Demographics
NPI:1437247830
Name:KERR, DONALD E (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:E
Last Name:KERR
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:PO BOX 1028
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47547-1028
Mailing Address - Country:US
Mailing Address - Phone:812-481-8493
Mailing Address - Fax:812-481-8497
Practice Address - Street 1:250 HIGH STREET
Practice Address - Street 2:
Practice Address - City:SHOALS
Practice Address - State:IN
Practice Address - Zip Code:47581
Practice Address - Country:US
Practice Address - Phone:812-247-2733
Practice Address - Fax:812-247-2373
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ININ01032897207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100166780Medicaid
110186107OtherRAIL ROAD MEDICARE
110186107OtherRAIL ROAD MEDICARE
INC25204Medicare UPIN