Provider Demographics
NPI:1225693492
Name:MCDONALD, ALEXANDER RICHARD (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:RICHARD
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 1:123 N BLOUNT ST UNIT 404
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-4602
Mailing Address - Country:US
Mailing Address - Phone:636-293-6316
Mailing Address - Fax:
Practice Address - Street 1:123 N BLOUNT ST UNIT 404
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-4602
Practice Address - Country:US
Practice Address - Phone:636-293-6316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WI76079-202085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program