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Contact Information

DELOYN L MCDONOUGH, PA-C
9026 HIWASSEE STREET NE
CHARLESTON, TN37310
 Phone: 423-665-3666
 Fax: 423-584-6747
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for DELOYN L MCDONOUGH · (Male)

NPI # 1487662672
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 08/03/2006
Last updated 08/02/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • TN License # 0121
  • TN Medicaid 1512988
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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