Healthcare Provider Details

I. General information

NPI: 1982539581
Provider Name (Legal Business Name): MAVIS J DONNELLY MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7345 E TANQUE VERDE RD
TUCSON AZ
85715-3475
US

IV. Provider business mailing address

7345 E TANQUE VERDE RD
TUCSON AZ
85715-3475
US

V. Phone/Fax

Practice location:
  • Phone: 520-748-2650
  • Fax: 520-296-2301
Mailing address:
  • Phone: 520-748-2650
  • Fax: 520-296-2301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MAVIS J DONNELLY
Title or Position: PRESIDENT
Credential: MD
Phone: 520-748-2650