Provider Demographics
NPI:1730574187
Name:MCDONALD, ERIC NILES (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:NILES
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BLUEGRASS CARE NAVIGATORS
Mailing Address - Street 2:1733 HARRODSBURG RD
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40514-3617
Mailing Address - Country:US
Mailing Address - Phone:859-276-5344
Mailing Address - Fax:859-278-7690
Practice Address - Street 1:BLUEGRASS CARE NAVIGATORS
Practice Address - Street 2:1733 HARRODSBURG RD
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3617
Practice Address - Country:US
Practice Address - Phone:859-276-5344
Practice Address - Fax:859-278-7690
Is Sole Proprietor?:No
Enumeration Date:2015-04-02
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS24756207P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program