Provider Demographics
NPI:1215268586
Name:MCPHERSON, DONALD (NP)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:MCPHERSON
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1988
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41702-1988
Mailing Address - Country:US
Mailing Address - Phone:606-435-7642
Mailing Address - Fax:606-436-5282
Practice Address - Street 1:145 CITIZENS LANE
Practice Address - Street 2:SUITE B
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41702-1988
Practice Address - Country:US
Practice Address - Phone:606-439-1300
Practice Address - Fax:606-439-1400
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-26
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6344P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily