Provider Demographics
NPI:1053356477
Name:JOHN Z. MCDONALD, D.O
Entity type:Organization
Organization Name:JOHN Z. MCDONALD, D.O
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:Z
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-355-7900
Mailing Address - Street 1:523 BUSTLETON PIKE
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6051
Mailing Address - Country:US
Mailing Address - Phone:215-355-7900
Mailing Address - Fax:215-355-9005
Practice Address - Street 1:523 BUSTLETON PIKE
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6051
Practice Address - Country:US
Practice Address - Phone:215-355-7900
Practice Address - Fax:215-355-9005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004867L207Q00000X
PAOS010843L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009046530002Medicaid
PA0009046530002Medicaid
PAC33950Medicare UPIN
PA709878Medicare PIN