Provider Demographics
NPI:1679997316
Name:DONOHUE, KENNETH WILLIAM (PA)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:WILLIAM
Last Name:DONOHUE
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Gender:M
Credentials:PA
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Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0388
Mailing Address - Country:US
Mailing Address - Phone:540-932-5162
Mailing Address - Fax:540-932-5875
Practice Address - Street 1:51 IVY RIDGE LN
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2339
Practice Address - Country:US
Practice Address - Phone:540-245-7262
Practice Address - Fax:540-245-7054
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2023-08-11
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Provider Licenses
StateLicense IDTaxonomies
VA0110004489363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant