Provider Demographics
NPI:1447240700
Name:DONELON, SHAWN ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:ELIZABETH
Last Name:DONELON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1587 N BOLTON AVE
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-4205
Mailing Address - Country:US
Mailing Address - Phone:318-445-9823
Mailing Address - Fax:318-445-1509
Practice Address - Street 1:1587 N BOLTON AVE
Practice Address - Street 2:SUITE 1100
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-4205
Practice Address - Country:US
Practice Address - Phone:318-445-9823
Practice Address - Fax:318-445-1509
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA025456207RN0300X
LAMD.025456207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1575267Medicaid
LAI43004Medicare UPIN
LA4J928Medicare PIN