MEDICARE: JOSEPH M DONALDSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	46667	AZ

General Provider Information

NPI Number	:	1306006317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH M DONALDSON MD

Provider Business Mailing Address
First Line	:	2610 E UNIVERSITY DR
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85213-8436
Country	:	US
Telephone Number	:	480-892-8400
Fax Number	:	480-892-1889

Provider Business Practice Location Address
First Line	:	2610 E UNIVERSITY DR
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85213-8436
Country	:	US
Telephone Number	:	480-892-8400
Fax Number	:	480-892-9533

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2008
Last Update Date	:	07/21/2017

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