Provider Demographics
NPI:1427139948
Name:DONALD A. MACDONALD, MD
Entity type:Organization
Organization Name:DONALD A. MACDONALD, MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MACDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-741-1902
Mailing Address - Street 1:21 GILBERT ST NORTH
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4905
Mailing Address - Country:US
Mailing Address - Phone:732-741-1902
Mailing Address - Fax:732-741-1919
Practice Address - Street 1:21 GILBERT ST NORTH
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07701-4905
Practice Address - Country:US
Practice Address - Phone:732-741-1902
Practice Address - Fax:732-741-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ439197Medicare PIN