Doctor Name: | DR. GEORGE FRED MCDONNOLD |
NPI Number: | 1386932986 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 6434 |
Business Practice Address: | 2973 Rolling Stone Rd Oklahoma City, OK - 731201921 |
Business Phone Number: | 4057514611 |
Business Fax Number: | |
Mailing Address: | 2973 Rolling Stone Rd, OKLAHOMA CITY |
State: | OK |
Postal Code: | 731201921 |
Phone Number: | 4057514611 |
Fax Number: | |
NPI Enumeration Date: | 07/16/2011 |
NPI Last Update Date: | 07/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 6434 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |