1003845371 NPI number — DR. JOHN E MCGINTY IV M.D.

Table of content: DR. JOHN E MCGINTY IV M.D. (NPI 1003845371)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003845371 NPI number — DR. JOHN E MCGINTY IV M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCGINTY
Provider First Name:
JOHN
Provider Middle Name:
E
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
IV
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003845371
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/17/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 REID PKWY
Provider Second Line Business Mailing Address:
MEDICAL STAFF SERVICES
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47374-1157
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
765-962-1337
Provider Business Mailing Address Fax Number:
765-966-0858

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 REID PKWY
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47374-1157
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-962-1337
Provider Business Practice Location Address Fax Number:
765-966-0858
Provider Enumeration Date:
06/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  01062763A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RC0000X , with the licence number: 35.081311 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2410742 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000676852 . This is a "ANTHEM - RPA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200440850 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com