Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Donald Ray Jack, MD

Individual provider Basic Emergency Medical Technician · NPI 1497079875

Mr. Donald Ray Jack, MD is a Basic Emergency Medical Technician in Hollywood, California. Practices as a sole proprietor. Licensed in Kentucky.

Licensed in
KY
In the registry since
2010
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1644 Wilcox Ave
Hollywood, CA 90028-6206
Phone: (424) 202-0322
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Basic Emergency Medical Technician (primary) Taxonomy 146N00000X · Licence 12521464546464 (KY)

Record details

NPI number1497079875
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 15, 2010
Last updated in NPPESMarch 15, 2010