Provider Demographics
NPI:1518997329
Name:MAPLES, DONALD L JR (DO)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:L
Last Name:MAPLES
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:DONALD
Other - Middle Name:LEE
Other - Last Name:MAPLES
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:315 S OSTEOPATHY AVE
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-6401
Mailing Address - Country:US
Mailing Address - Phone:660-785-1000
Mailing Address - Fax:
Practice Address - Street 1:315 S OSTEOPATHY AVE
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-6401
Practice Address - Country:US
Practice Address - Phone:660-785-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36804207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00786270OtherRR MEDICARE
MO1518997329Medicaid
MO1518997329Medicaid
MO501150009Medicare PIN
MOE65876Medicare UPIN