Healthcare Provider Details
I. General information
NPI: 1932108743
Provider Name (Legal Business Name): DANA FRANCIS MCGINN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 07/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
238 WESTERN AVE
BRATTLEBORO VT
05301-6246
US
IV. Provider business mailing address
238 WESTERN AVE
BRATTLEBORO VT
05301-6246
US
V. Phone/Fax
- Phone: 802-257-5111
- Fax: 802-254-0178
- Phone: 802-257-5111
- Fax: 802-254-0178
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | 042-0007090 |
| License Number State | VT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: