Anderson, Donovan John

Anderson, Donovan John is an individual health care provider with primary practice located at 8700 Highway 95 , Mohave Valley AZ 86440-8519. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Anderson, Donovan John can be contacted via phone (928) 768-7113.

Contact Information

Primary practice address
8700 Highway 95 Mohave Valley AZ 86440-8519
Phone: (928) 768-7113
Fax: (928) 788-2481
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 13491 Arizona

Profile Details

NPI number 1356333058
LBN Legal business name Anderson, Donovan John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356333058 NPPES
California MEDICAID XPY055881
California MEDICAID 205288-01

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