Healthcare Provider Details

I. General information

NPI: 1174518930
Provider Name (Legal Business Name): JOHN ADAM MACPHAIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 01/17/2018
Certification Date:
Deactivation Date: 03/25/2006
Reactivation Date: 04/06/2006

III. Provider practice location address

126 E CHURCH ST STE 2100
SOMERSET PA
15501-2271
US

IV. Provider business mailing address

329 S PLEASANT AVE
SOMERSET PA
15501-2262
US

V. Phone/Fax

Practice location:
  • Phone: 814-445-1281
  • Fax: 814-443-3214
Mailing address:
  • Phone: 814-445-3575
  • Fax: 814-445-5700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2009-02130
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD021853E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: