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General NPI Number Information
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NPI Number | 1760533533
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Entity Type | Individual
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Provider Name | BEN O'NEILL DONOVAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 15000 N 83RD AVE UNIT 304
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City | PEORIA
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State | AZ
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Zip | 85381-2004
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Country | US
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Telephone | 623-887-2912
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Fax | 480-882-5085
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Provider Business Mailing Address
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Address Line | 15000 N 83RD AVE UNIT 200
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City | PEORIA
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State | AZ
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Zip | 85381-2002
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Country | US
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Telephone | 623-887-2912
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Fax | 480-882-5085
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2088P0231X
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Taxonomy Name | Pediatric Urology Physician
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License Number | 37764
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 22961
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License Number State | OK
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