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NPI Code Detail

MEDICARE: THOMAS PINCKNEY MCILWAIN M.D.

MEDICARE: THOMAS PINCKNEY MCILWAIN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician31174NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124022942
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS PINCKNEY MCILWAIN M.D.
Provider Business Mailing Address
First Line : 3425 MELROSE RD
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-1608
Country : US
Telephone Number : 910-609-3700
Fax Number : 910-609-3784
Provider Business Practice Location Address
First Line : 3425 MELROSE RD
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-1608
Country : US
Telephone Number : 910-609-3700
Fax Number : 910-609-3784
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 07/09/2007

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