Provider Demographics
NPI:1396317707
Name:O'DONNELL, THOMAS JOHN
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOHN
Last Name:O'DONNELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 NORTH CLAYTON STREET
Mailing Address - Street 2:SAINT FRANCIS FAMILY MEDICINE, MSB 2ND FLOOR
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805
Mailing Address - Country:US
Mailing Address - Phone:302-575-8040
Mailing Address - Fax:302-575-8005
Practice Address - Street 1:701 N CLAYTON ST
Practice Address - Street 2:SAINT FRANCIS FAMILY MEDICINE, MSB 2ND FLOOR
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3155
Practice Address - Country:US
Practice Address - Phone:302-575-8040
Practice Address - Fax:302-575-8005
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program