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General NPI Number Information
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NPI Number | 1457821548
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Entity Type | Organization
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Legal Business Name | JAMES MCGINN LLC
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Dates
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Enumeration Date | 11/30/2018
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Last Update Date | 11/30/2018
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Provider Practice Location Address
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Address Line | 849 E 33RD ST STE 201B
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City | EDMOND
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State | OK
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Zip | 73013-5407
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Country | US
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Telephone | 480-330-5472
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Fax |
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Provider Business Mailing Address
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Address Line | 738 W PERRY DR
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City | MUSTANG
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State | OK
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Zip | 73064-3702
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Country | US
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Telephone | 480-330-5472
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAMES D MCGINN III
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Credential | NP
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Telephone | 480-330-5472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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