Provider Demographics
NPI:1811542749
Name:O'DONNELL ORTHOPAEDICS
Entity Type:Organization
Organization Name:O'DONNELL ORTHOPAEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:O'DONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:267-639-2555
Mailing Address - Street 1:702 N 3RD ST # 804
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-2904
Mailing Address - Country:US
Mailing Address - Phone:267-639-2555
Mailing Address - Fax:215-613-5631
Practice Address - Street 1:2200 HAMILTON ST STE 214
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-6329
Practice Address - Country:US
Practice Address - Phone:484-273-0401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-07
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty