Individual
LILLY KATHERINE MCGONEGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2900 STATE ST, MEDFORD, OR 97504-8458
(541) 779-1672
Mailing address
2900 STATE ST, MEDFORD, OR 97504-8458
(541) 779-1672
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
10/31/2024
Last updated
10/31/2024
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