Provider Demographics
NPI:1407220783
Name:O'DONNELL MEDICAL SERVICES, LLC
Entity type:Organization
Organization Name:O'DONNELL MEDICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:F
Authorized Official - Last Name:O'DONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-272-2346
Mailing Address - Street 1:233 W GERMANTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-1331
Mailing Address - Country:US
Mailing Address - Phone:610-272-2346
Mailing Address - Fax:610-277-7261
Practice Address - Street 1:233 W GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-1331
Practice Address - Country:US
Practice Address - Phone:610-272-2346
Practice Address - Fax:610-277-7261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015881207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOS015881OtherSTATE LICENSE