Organization
MARK E. DONNELLY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK E DONNELLY M.D. (PRESIDENT)
(928) 773-2200
Entity
Organization
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 773-2200
(928) 773-2201
Mailing address
PO BOX 1356, FLAGSTAFF, AZ 86002-1356
(928) 773-2200
(928) 773-2201
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC4814
RAILROAD MEDICARE
AZ
Enumeration date
11/01/2006
Last updated
01/23/2008
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