Provider Demographics
NPI:1396792834
Name:DONOHUE, JOHN A (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:DONOHUE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1287
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85139-0380
Mailing Address - Country:US
Mailing Address - Phone:520-494-7788
Mailing Address - Fax:520-494-7789
Practice Address - Street 1:44302 W MARICOPA CASA GRANDE HWY
Practice Address - Street 2:C-1
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-2942
Practice Address - Country:US
Practice Address - Phone:520-494-7788
Practice Address - Fax:520-494-7789
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5096111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZDC5096Medicare ID - Type Unspecified