Provider Demographics
NPI:1447219688
Name:QUINN, DONALD ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ROBERT
Last Name:QUINN
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 1:6 6TH ST STE 256
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-2257
Mailing Address - Country:US
Mailing Address - Phone:234-573-1502
Mailing Address - Fax:423-217-0604
Practice Address - Street 1:6 6TH ST STE 256
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-2257
Practice Address - Country:US
Practice Address - Phone:234-573-1502
Practice Address - Fax:423-217-0604
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24122207R00000X, 208M00000X
VA0101234588207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010101701Medicaid
TN3072748Medicaid
TN3072748Medicaid
TN103I818172Medicare PIN
VA010101701Medicaid
TN3072748Medicare PIN
VAMC10382Medicare PIN