MEDICARE: MEGHAN ELIZABETH MCDONOUGH PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	3526	SC
2	363AS0400X	Surgical Physician Assistant	6852	TN

General Provider Information

NPI Number	:	1558971820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN ELIZABETH MCDONOUGH PA

Provider Business Mailing Address
First Line	:	PO BOX 80426
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37414-7426
Country	:	US
Telephone Number	:	423-495-8659
Fax Number	:

Provider Business Practice Location Address
First Line	:	2051 HAMILL RD STE 201
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-4653
Country	:	US
Telephone Number	:	423-541-1125
Fax Number	:	423-541-1126

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2020
Last Update Date	:	03/17/2026

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