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NPI Code Detail

MEDICARE: DR. TIMOTHY ROBERT MCGAURN D.C.

MEDICARE: DR. TIMOTHY ROBERT MCGAURN D.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
1111N00000XChiropractor38MC00183800NJ

General Provider Information

NPI Number : 1831130095
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY ROBERT MCGAURN D.C.
Provider Business Mailing Address
First Line : 6650 BROWNING RD
Second Line :
City : PENNSAUKEN
State : NJ
Zip : 08109-1479
Country : US
Telephone Number : 856-663-4414
Fax Number : 856-486-9064
Provider Business Practice Location Address
First Line : 6650 BROWNING RD
Second Line :
City : PENNSAUKEN
State : NJ
Zip : 08109-1479
Country : US
Telephone Number : 856-663-4414
Fax Number : 856-486-9064
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 07/08/2007

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