Kenneth Lee McDonough, MD
Individual provider Active NPI Family Medicine Physician · Slayton, MN
NPI 1497023246 · NPPES record last updated Sep 24, 2018
Key facts
- NPI
- 1497023246
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 26423 (MN)
- Practice address
- 2042 Juniper Ave
Slayton, MN 56172-1017 - Phone
- (507) 836-6111
- NPI assigned
- Dec 8, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | 26423 | MN | |
| Family Medicine Physician | 207Q00000X | 26423 | MN | Yes |
Addresses
Primary practice location
2042 Juniper Ave
Slayton, MN 56172-1017
Mailing address
2042 Juniper Ave
Slayton, MN 56172-1017
Phone (302) 824-1458
Other practice location 1
550 Calibre Ln
Mount Juliet, TN 37122-6170
Phone (302) 824-1458
Other providers in Slayton, MN
- Jennifer Lynn Krikrou
- Maci Kruisselbrink
- Mae Beth Lindstrom-Wold
- LRN Associates Manaegement Services, Inc
- Cara Rae Mahon
- Kara Miller
- Jenna Lee Mollema
- Joseph Hamilton Muldoon
- Murray County Central Isd#2169
- Murray County Transportation
All providers in Slayton, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.