Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Richard E Donnelly, PA-C

Individual provider Surgical Physician Assistant · NPI 1396729455

Richard E Donnelly, PA-C is a Surgical Physician Assistant in Lakeside, Arizona. Practices as a sole proprietor. Licensed in Arizona and Minnesota.

Licensed in
AZ, MN
In the registry since
2005
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

43 W White Mountain Blvd
Lakeside, AZ 85929-7002
Phone: (928) 367-4040
Fax: (928) 367-4042
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 1105 (AZ)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 10186 (MN)

Record details

NPI number1396729455
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedDecember 2, 2005
Last updated in NPPESFebruary 16, 2011