Provider Demographics
NPI:1811953714
Name:MCDONALD, JAMES F JR (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:MCDONALD
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 W HUNTING PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1302
Mailing Address - Country:US
Mailing Address - Phone:215-707-8484
Mailing Address - Fax:215-707-3946
Practice Address - Street 1:3509 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-4105
Practice Address - Country:US
Practice Address - Phone:215-707-8484
Practice Address - Fax:215-707-3946
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004000L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00691520OtherRR MEDICARE
PA128726FSEOtherMEDICARE GROUP
PAP00753268OtherRAILROAD MEDICARE
PA000740274Medicaid
PA597586JTQOtherMEDICARE GROUP
PA128726FSEMedicare PIN
PAP00753268OtherRAILROAD MEDICARE
PAP00691520OtherRR MEDICARE