Provider Demographics
NPI:1154798569
Name:MCDONALD, KATHARINE LEE (PA-C)
Entity type:Individual
Prefix:MS
First Name:KATHARINE
Middle Name:LEE
Last Name:MCDONALD
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:KATHARINE
Other - Middle Name:JOYCE
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 100265
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0265
Mailing Address - Country:US
Mailing Address - Phone:352-273-9000
Mailing Address - Fax:352-392-8413
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-4218
Practice Address - Country:US
Practice Address - Phone:352-273-9000
Practice Address - Fax:352-392-8413
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9108772363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9108772OtherLICENSE NUMBER