Provider Demographics
NPI:1033170295
Name:MCGAHEN, JOEL HOWARD (OD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:HOWARD
Last Name:MCGAHEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 PHOENIX DR
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4537
Mailing Address - Country:US
Mailing Address - Phone:717-264-4012
Mailing Address - Fax:717-264-5745
Practice Address - Street 1:422 PHOENIX DR
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4537
Practice Address - Country:US
Practice Address - Phone:717-264-4012
Practice Address - Fax:717-264-5745
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000370152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA410030903OtherMEDICARE RAILROAD
PADG4563OtherMEDICARE RAILROAD
PA0689920001Medicare NSC
PADG4563OtherMEDICARE RAILROAD
PAT29987Medicare UPIN