Healthcare Provider Details

I. General information

NPI: 1477982783
Provider Name (Legal Business Name): JOHN HEDRICK MCGINNISS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2013
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HEALTH CLINIC QUANTICO
APO AA
22134
US

IV. Provider business mailing address

4519 SHELLEYS XING
HUNTINGTOWN MD
20639-3004
US

V. Phone/Fax

Practice location:
  • Phone: 703-784-1500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number7381
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: