Individual
JACY D DONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
512 W ATLANTA ST, BROKEN ARROW, OK 74012-7004
(918) 370-4461
(918) 512-4723
Mailing address
5310 E 31ST ST STE LL, TULSA, OK 74135-5018
(918) 236-4000
(918) 236-4001
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
7721
OK
Other
Enumeration date
03/22/2021
Last updated
07/04/2025
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