Provider Demographics
NPI:1134228422
Name:MCDONALD, WILLIAM JOHN (MD PA)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOHN
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 NORTH FEDERAL HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-2352
Mailing Address - Country:US
Mailing Address - Phone:561-585-9891
Mailing Address - Fax:561-585-5801
Practice Address - Street 1:1028 NORTH FEDERAL HIGHWAY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-2352
Practice Address - Country:US
Practice Address - Phone:561-585-9891
Practice Address - Fax:561-585-5801
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME18249207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D62684Medicare UPIN
FL50597Medicare ID - Type Unspecified