Individual
DR. KENNETH LEE MCDONOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2042 JUNIPER AVE, SLAYTON, MN 56172-1017
(507) 836-6111
Mailing address
2042 JUNIPER AVE, SLAYTON, MN 56172-1017
(302) 824-1458
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26423
MN
2083X0100X
Occupational Medicine Physician
26423
MN
Other
Enumeration date
12/08/2011
Last updated
09/24/2018
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