Individual
DONOVAN JOHN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8700 HIGHWAY 95, MOHAVE VALLEY, AZ 86440-8519
(928) 768-7113
(928) 788-2481
Mailing address
8700 HIGHWAY 95, MOHAVE VALLEY, AZ 86440-8519
(928) 768-7113
(928) 788-2481
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13491
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205288-01
—
AZ
05
—
XPY055881
—
CA
Enumeration date
08/18/2005
Last updated
07/08/2007
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