Basic Information
| Provider Information | |||||||||
| NPI: | 1760772594 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DONALDSON | ||||||||
| FirstName: | BROOKE | ||||||||
| MiddleName: | LARAE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13686 WILLS RD SE | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430569305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7406448943 | ||||||||
| FaxNumber: | 8669402351 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 FOREST AVE | ||||||||
| Address2: | |||||||||
| City: | ZANESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437012821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404557625 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2011 | ||||||||
| LastUpdateDate: | 08/12/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 35.120848 | OH | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.