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NPI Code Detail

MEDICARE: DR. JACQUELYN ANN MCGILL M.D.

MEDICARE: DR. JACQUELYN ANN MCGILL 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
1207Q00000XFamily Medicine Physician172956NC

General Provider Information

NPI Number : 1356635528
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACQUELYN ANN MCGILL M.D.
Provider Business Mailing Address
First Line : PO BOX 96860
Second Line :
City : CHARLOTTE
State : NC
Zip : 28296-6860
Country : US
Telephone Number : 919-359-1011
Fax Number :
Provider Business Practice Location Address
First Line : 236 BUTTERNUT LN
Second Line :
City : CLAYTON
State : NC
Zip : 27520-5857
Country : US
Telephone Number : 919-359-1011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2011
Last Update Date : 02/04/2026

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