Provider Demographics
NPI:1558339234
Name:DONALD, JAMES S (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:DONALD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1237
Mailing Address - Street 2:
Mailing Address - City:CHATOM
Mailing Address - State:AL
Mailing Address - Zip Code:36518-1237
Mailing Address - Country:US
Mailing Address - Phone:251-847-6262
Mailing Address - Fax:251-847-6277
Practice Address - Street 1:14634 SAINT STEPHENS AVE
Practice Address - Street 2:
Practice Address - City:CHATOM
Practice Address - State:AL
Practice Address - Zip Code:36518-6711
Practice Address - Country:US
Practice Address - Phone:251-847-6262
Practice Address - Fax:251-847-6277
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL00018354207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000097391Medicaid
AL529905180Medicaid
AL000097391Medicaid
AL000097391Medicare PIN