Healthcare Provider Details

I. General information

NPI: 1518930718
Provider Name (Legal Business Name): TERENCE MICHAEL MCGEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 CHILD ST
JACKSONVILLE FL
32214-5005
US

IV. Provider business mailing address

2080 CHILD ST
JACKSONVILLE FL
32214-5005
US

V. Phone/Fax

Practice location:
  • Phone: 904-542-7680
  • Fax: 904-542-7687
Mailing address:
  • Phone: 904-542-7680
  • Fax: 904-542-7687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35167
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: