DR. MARK W MCDONALD (NPI# 1407140106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407140106 |
| Entity Type | Individual |
| Full Name | DR. MARK W MCDONALD |
| Credential | MD |
| Practice Address |
629 Winding Brook Ln Tyler TX 75703-0832 |
| Practice Telephone | 9033524840 |
| Practice Fax Number | 9033524840 |
| Mailing Telephone | 9033524840 |
| Mailing Fax Number | 9033524840 |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2017-01-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 206929 | LA | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | BP10041308 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2367145 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093795122 | Mark Newton Mcdonald | Dentist | Bldg 2441 21st Street, Usa Dentac, Fort Campbell, KY 42223-5369 | 2006-01-17 |
| 1861479479 | Mark C Mcdonald | Physician Assistant | 8700 W Watertown Plank Rd, Orthopaedic Surgery, Milwaukee, WI 53226 | 2005-12-23 |
| 1366837429 | Mark M Mcdonald | Psychiatry & Neurology | 1221 Lee Street, Charlottesville, VA 22908-0816 | 2015-04-05 |
| 1861818494 | Mark Mcdonald | Physical Therapist | 1450 Route 208, Wallkill, NY 12589-3799 | 2014-03-06 |
| 1386078061 | Mark Mcdonald | Counselor | 1202 S James Campbell Blvd, Ste 7a, Columbia, TN 38401-5193 | 2013-08-29 |
| 1750632048 | Mark Zachary Mcdonald | Physical Therapist | 1114 W Jackson St, Ozark, MO 65721-9164 | 2012-09-26 |
| 1144408287 | Mark William Mcdonald | Radiology | 1365 Clifton Rd Ne, Suite A1341, Atlanta, GA 30322-1013 | 2008-01-31 |
| 1770766305 | Mark E Mcdonald | Adult Companion | 2908 Ne Killingsworth St, Portland, OR 97211-6812 | 2007-12-05 |
| 1114116506 | Mark Mcdonald | Psychiatry & Neurology | 11500 W Olympic Blvd, Suite 426, Los Angeles, CA 90064-1524 | 2007-10-22 |
| 1063604429 | Mark T Mcdonald | Dentist | 1601 12th Ave Rd, Suite 103, Nampa, ID 83686-7711 | 2007-08-09 |
| Street Address |
629 WINDING BROOK LN |
| City | TYLER |
| State | TX |
| Zip Code | 75703-0832 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1770052532 | Refinery Chiropractic LLC | Chiropractor | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | 2018-11-21 |
| 1215419353 | Deidre Lynn Fergason | Occupational Therapy Assistant | 3505 Old Jacksonville Hwy, Tyler, TX 75703 | 2018-09-05 |
| 1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
| 1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
| 1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
| 1427572544 | Cody Wayne Graham | Pharmacist | 5415 S. Broadway Ave., Tyler, TX 75703 | 2017-07-31 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1427570084 | Darah Lynne Dahlem | Speech-Language Pathologist | 401 E. Front Street Ste 123, Tyler, TX 75703 | 2017-07-14 |
| 1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
| Find all providers in zip 75703 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922632553 | Christina Kay Baker | Family Medicine | 2333 Dueling Oaks Dr, Tyler, TX 75703-0326 | 2020-02-21 |
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1396389870 | Shelly Lynn Williams | Family Medicine | 1420 W Southwest Loop 323 Ste 100, Tyler, TX 75701-9347 | 2019-10-29 |
| 1891354494 | Beverly Diann Butler | Family Medicine | 5604 Old Bullard Rd Ste 107, Tyler, TX 75703-4359 | 2019-06-07 |
| 1851846018 | Thomas Mason Worthington Jr. | Family Medicine | 9141 Chisholm Trl, Tyler, TX 75703-0409 | 2016-08-17 |
| 1881069557 | The Bradley Clinic of Texas, Pllc | Family Medicine | 1402 Rice Rd, Suite 100, Tyler, TX 75703-3260 | 2015-12-07 |
| 1750764189 | Diabetic Renewal Center LLC | Family Medicine | 1015 Pruitt Pl Ste 105, Tyler, TX 75703-1154 | 2015-07-02 |
| 1013306273 | Pure Radiance Laser Retreat | Family Medicine | 6722 S Broadway Ave, Tyler, TX 75703-4730 | 2015-01-12 |
| 1023412988 | James Kent Gray | Family Medicine | 14843 Big Oak Bay Rd, Tyler, TX 75707-7309 | 2014-10-21 |
| 1346640182 | Morris Mht LLC | Family Medicine | 2030 Stonegate Blvd, Tyler, TX 75703-0103 | 2014-08-29 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.