Provider Demographics
NPI:1538699715
Name:MACDONALD, ASHTON COFFEY (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHTON
Middle Name:COFFEY
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W PARK CIR STE C
Mailing Address - Street 2:
Mailing Address - City:NORTH WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-3583
Mailing Address - Country:US
Mailing Address - Phone:336-903-7870
Mailing Address - Fax:336-903-7871
Practice Address - Street 1:200 W PARK CIR STE C
Practice Address - Street 2:
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3583
Practice Address - Country:US
Practice Address - Phone:336-903-7870
Practice Address - Fax:336-903-7871
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-07274363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical