Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Kenneth Willoughby Jr., PA-C

Individual provider Medical Physician Assistant · NPI 1427240019

Mr. Kenneth Willoughby Jr., PA-C is a Medical Physician Assistant in Avon Lake, Ohio. Licensed in South Carolina. Registered with an NPI since 2007.

Licensed in
SC
In the registry since
2007
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

32051 Grove St
Avon Lake, OH 44012-1906
Phone: (440) 930-2802
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4370 (SC)
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1427240019
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 16, 2007
Last updated in NPPESMay 6, 2025
Certification dateMay 6, 2025