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1023025319
IRVIN CORDELL MCDONALD
JACKSON, MS
NPI
1023025319
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP2300X Nurse Practitioner Primary Care
(Licence: MS R588806)
Enumeration Date
2006-08-01
Last Update Date
2007-07-08
Business Address
MR. IRVIN CORDELL MCDONALD NP
1500 E WOODROW WILSON AVE
JACKSON, MS 39216-5116
Phone number: 601-362-4471
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Mailing Address
MR. IRVIN CORDELL MCDONALD NP
288 PARKS RD
JACKSON, MS 39212-9601
Phone number: 601-362-4471
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