Provider Demographics
NPI:1013983188
Name:MACKLER, DONALD FRANKLIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:FRANKLIN
Last Name:MACKLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 GLENWOOD DR
Mailing Address - Street 2:STE. W552
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1106
Mailing Address - Country:US
Mailing Address - Phone:423-629-6258
Mailing Address - Fax:423-629-9531
Practice Address - Street 1:721 GLENWOOD DR
Practice Address - Street 2:STE. W552
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1106
Practice Address - Country:US
Practice Address - Phone:423-629-6258
Practice Address - Fax:423-629-9531
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000011215207RG0100X
WAMD60600917207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3388156Medicaid
GA00170475BMedicaid
GAGRP325Medicare ID - Type Unspecified
GA00170475BMedicaid
TN3388156Medicaid
VAGC1100Medicare PIN
TN3166949Medicare ID - Type Unspecified