Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RICHARD E DONNELLY, P.A.-C.
Active Sole ProprietorRICHARD E DONNELLY, P.A.-C. is a Surgical Physician Assistant healthcare provider located in LAKESIDE, Arizona. NPI 1396729455 is currently active in the NPPES registry. Verify at CMS.
Surgical Physician Assistant · LAKESIDE, AZ
Registration Details
- NPI Number
- 1396729455
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 2, 2005 (20.734788621423 yrs)
- Last Updated
- Feb 16, 2011
- Licenses
-
1105 (AZ)10186 (MN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
43 W. WHITE MOUNTAIN BLVDLAKESIDE, AZ, 859297002Browse AZ providers · Browse ZIP 85929
- Phone
- 9283674040
- Fax
- 9283674042
- Primary Specialty
-
Surgical Physician Assistant
363AS0400X
- Additional Specialty
- Surgical Physician Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.