Provider Demographics
NPI:1578665899
Name:MONDRAGON, DONALD GENE II (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:GENE
Last Name:MONDRAGON
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:300 W HOSPITAL RD
Mailing Address - Street 2:INTERNAL MEDICINE CLINIC
Mailing Address - City:FORT GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:30905-5741
Mailing Address - Country:US
Mailing Address - Phone:706-787-6462
Mailing Address - Fax:706-787-0005
Practice Address - Street 1:300 W HOSPITAL RD
Practice Address - Street 2:INTERNAL MEDICINE CLINIC
Practice Address - City:FORT GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905-5741
Practice Address - Country:US
Practice Address - Phone:706-787-6462
Practice Address - Fax:706-787-0005
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2013-10-04
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Provider Licenses
StateLicense IDTaxonomies
OH35.055876207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine