Donovan, Jacqueline Kathryn

Donovan, Jacqueline Kathryn is an individual health care provider with primary practice located at 23175 Commerce Park Ste C , Beachwood OH 44122-5806. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is her primary health care specialty. Donovan, Jacqueline Kathryn can be contacted via phone (216) 299-6774.

Contact Information

Primary practice address
23175 Commerce Park Ste C Beachwood OH 44122-5806
Phone: (216) 299-6774
Fax: (440) 583-3097
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 36003737 Ohio
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 36.003737 Ohio

Profile Details

NPI number 1225394596
LBN Legal business name Donovan, Jacqueline Kathryn
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2012
Last updated Oct 18th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225394596 NPPES
Ohio MEDICAID 0424757

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