Provider Demographics
NPI:1285625087
Name:DONALDSON, SCOTT G (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:G
Last Name:DONALDSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:375 MUNICIPAL DR
Mailing Address - Street 2:SUITE 218
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3559
Mailing Address - Country:US
Mailing Address - Phone:972-680-0666
Mailing Address - Fax:
Practice Address - Street 1:375 MUNICIPAL DR
Practice Address - Street 2:SUITE 218
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3559
Practice Address - Country:US
Practice Address - Phone:972-680-0666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH2112207RP1001X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX105594901Medicaid
TXE33295Medicare UPIN
TX87K482Medicare ID - Type Unspecified