Provider Demographics
NPI:1013957976
Name:MCDONALD, GARY R (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:R
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:104 WOODMONT BLVD
Mailing Address - Street 2:SUITE LL50
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2245
Mailing Address - Country:US
Mailing Address - Phone:615-386-2300
Mailing Address - Fax:615-386-2399
Practice Address - Street 1:4230 HARDING RD
Practice Address - Street 2:SUITE 400
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-297-2700
Practice Address - Fax:615-269-4584
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2014-08-07
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Provider Licenses
StateLicense IDTaxonomies
TN20283207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN12219843OtherMULTIPLAN/PHCS
KY64916265Medicaid
TN977796OtherUNITED HEALTH CARE
TN1074558OtherUSA MCO
TN3164324OtherBLUE CROSS OF TN
TN10078366OtherAMERIGROUP
TN1507823Medicaid
TN110220160OtherMEDICARE RR
TN2571436OtherCIGNA
TN977796OtherUNITED HEALTH CARE
F25857Medicare UPIN