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NPI Code Detail

MEDICARE: DR. JAMES LEO MCGAULEY MD

MEDICARE:  DR. JAMES LEO MCGAULEY  MD
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
1207T00000XNeurological Surgery Physician4301030979MI
2207T00000XNeurological Surgery Physician71333641205UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14301030979OTHERMISTATE LICENSE
271333641205OTHERUTSTATE LICENSE

General Provider Information

NPI Number : 1689819146
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES LEO MCGAULEY MD
Provider Business Mailing Address
First Line : 8884 ALPEN WAY
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84121-6159
Country : US
Telephone Number : 801-580-7071
Fax Number :
Provider Business Practice Location Address
First Line : 8884 ALPEN WAY
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84121-6159
Country : US
Telephone Number : 801-580-7071
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2008
Last Update Date : 12/11/2008

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Directions to “ DR. JAMES LEO MCGAULEY MD” Practice Location

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