MEDICARE: MR. TERRY L MCPHERSON PA-C

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
1	363AS0400X	Surgical Physician Assistant	PA757	KY

Other Identifiers

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

General Provider Information

NPI Number	:	1144228040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TERRY L MCPHERSON PA-C

Provider Business Mailing Address
First Line	:	78 SUMMERTREE DR
Second Line	:
City	:	NICHOLASVILLE
State	:	KY
Zip	:	40356-9714
Country	:	US
Telephone Number	:	859-553-6474
Fax Number	:	859-901-0015

Provider Business Practice Location Address
First Line	:	78 SUMMERTREE DR
Second Line	:
City	:	NICHOLASVILLE
State	:	KY
Zip	:	40356-9714
Country	:	US
Telephone Number	:	859-553-6474
Fax Number	:	859-901-0015

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	02/18/2026

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