Healthcare Provider Details

I. General information

NPI: 1710042676
Provider Name (Legal Business Name): KAREN J. M. DONATO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN J.M. DONATO PA

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 MARTIN LUTHER KING JR BLVD
MACON GA
31201-3297
US

IV. Provider business mailing address

640 MARTIN LUTHER KING JR BLVD STE 200
MACON GA
31201-3297
US

V. Phone/Fax

Practice location:
  • Phone: 478-745-5455
  • Fax: 478-745-2915
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number005208
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: