Provider Demographics
NPI:1043385776
Name:MCGINN, THOMAS TERRELL JR (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:TERRELL
Last Name:MCGINN
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:DEPT AT 952581
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31192-2581
Mailing Address - Country:US
Mailing Address - Phone:504-455-9825
Mailing Address - Fax:504-883-7669
Practice Address - Street 1:4324 VETERANS MEMORIAL BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-5445
Practice Address - Country:US
Practice Address - Phone:504-455-9825
Practice Address - Fax:504-883-7669
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA1090-105T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1918709Medicaid
U19369Medicare UPIN
LA49789Medicare PIN