1558516831 NPI number — MS. JONI D MCGHEE OT

Table of content: MS. JONI D MCGHEE OT (NPI 1558516831)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558516831 NPI number — MS. JONI D MCGHEE OT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCGHEE
Provider First Name:
JONI
Provider Middle Name:
D
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
OT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558516831
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/13/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 657
Provider Second Line Business Mailing Address:
478 GREENE ROAD
Provider Business Mailing Address City Name:
DIERKS
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
71833-0657
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-651-8700
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
130 MEDICAL CIRCLE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71852
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-845-8161
Provider Business Practice Location Address Fax Number:
870-845-8284
Provider Enumeration Date:
11/30/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  106926 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XP0019X , with the licence number: OTR2569 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)