Organization Active NPI

D D McDonald MD & Associates

  • Family Medicine Physician
  • Longview, TX
National Provider Identifier
1356679757
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C5174 Issued in TX
Legal business name
D D MCDONALD MD & ASSOCIATES
Practice address
717 N 4TH St
Longview, TX 75601-5438
Phone
(903) 753-0306
Fax
(903) 753-0631
NPI assigned
Nov 23, 2009
Last updated
Feb 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Deward Dewitt McDonald, MD
Title
Physician/Officer
Phone
(903) 753-0306

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C5174 TX Primary

Addresses

Primary practice location

717 N 4TH St
Longview, TX 75601-5438

Mailing address

717 N 4TH St
Longview, TX 75601-5438
Phone (903) 753-0306

Other identifiers 2

IdentifierTypeStateIssuer
C5174OtherTXSTATE LISCENSE
031317301MedicaidTX

Other names 1

  • Dr. D.D. McDonald MD Other name

National Provider Directory

National Provider Directory

Locations

717 N 4th St
Longview, TX 75601
Phone (903) 753-0306

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265155200000",
    "number": "1356679757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 N 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015438",
            "telephone_number": "903-753-0306",
            "fax_number": "903-753-0631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 N 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015438",
            "telephone_number": "903-753-0306",
            "fax_number": "903-753-0631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D D MCDONALD MD & ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-23",
        "last_updated": "2010-02-03",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "DEWARD",
        "authorized_official_middle_name": "DEWITT",
        "authorized_official_title_or_position": "PHYSICIAN/OFFICER",
        "authorized_official_telephone_number": "903-753-0306",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "C5174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISCENSE",
            "identifier": "C5174",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031317301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. D.D. McDonald MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.