Healthcare Provider Details

I. General information

NPI: 1487344685
Provider Name (Legal Business Name): AILIS CLARE DOONER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2023
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 W BROWN RD
MESA AZ
85201-3203
US

IV. Provider business mailing address

570 W BROWN RD
MESA AZ
85201-3203
US

V. Phone/Fax

Practice location:
  • Phone: 480-344-2100
  • Fax: 602-655-9804
Mailing address:
  • Phone: 480-344-2100
  • Fax: 602-655-9804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number80475
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR80190
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: