1801841358 NPI number — MICHAEL CLIFTON MCGINNIS M.D.

Table of content: MICHAEL CLIFTON MCGINNIS M.D. (NPI 1801841358)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801841358 NPI number — MICHAEL CLIFTON MCGINNIS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCGINNIS
Provider First Name:
MICHAEL
Provider Middle Name:
CLIFTON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1801841358
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/20/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5700 SOUTHWYCK BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOLEDO
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43614-1509
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-288-8325
Provider Business Mailing Address Fax Number:
419-866-5453

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
911 SUNSET DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLLISTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95023-5606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-637-5711
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2006

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: 207ZP0102X , with the licence number:  141451 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207ZP0102X , with the licence number: 255317 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 2144647 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60015389 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 100208290A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 250774730N01 . This is a "HIP OF NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 302894 . This is a "AVMED,INC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5001628 . This is a "GHI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2359696000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P00208899 . This is a "RR MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P3431936 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100745580B . This is a "SOONERCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4093337 . This is a "AMERICAN TRAVELERS ASSUR." identifier . This identifiers is of the category "OTHER".
  • Identifier: 0052167 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1590753 . This is a "GHI" identifier , issued by the state of ( OK ) . This identifiers is of the category "OTHER".
  • Identifier: 2738769 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2K7528 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 39305 . This is a "UHP OF NJ" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 91001516800 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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