Provider Demographics
NPI:1881894046
Name:MACDONALD, ANGELA M (OD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:M
Last Name:MACDONALD
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Gender:F
Credentials:OD
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Mailing Address - Street 1:2800 SW WANAMAKER RD
Mailing Address - Street 2:SUITE 192
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-4293
Mailing Address - Country:US
Mailing Address - Phone:785-272-0707
Mailing Address - Fax:785-272-0575
Practice Address - Street 1:14 E PEORIA ST
Practice Address - Street 2:
Practice Address - City:PAOLA
Practice Address - State:KS
Practice Address - Zip Code:66071-1707
Practice Address - Country:US
Practice Address - Phone:913-294-4342
Practice Address - Fax:913-294-3309
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2012-02-13
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Provider Licenses
StateLicense IDTaxonomies
KS1764152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS4180220001Medicare NSC