Provider Demographics
NPI:1184855561
Name:MCGINNIS, JULIE HUTCHINSON (OD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:HUTCHINSON
Last Name:MCGINNIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:KATHLEEN
Other - Last Name:HUTCHINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1614 BELVEDERE AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-2914
Mailing Address - Country:US
Mailing Address - Phone:919-389-5565
Mailing Address - Fax:
Practice Address - Street 1:2406 W ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-8430
Practice Address - Country:US
Practice Address - Phone:704-226-1855
Practice Address - Fax:704-226-0695
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2433152W00000X
MO2009016927152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1184855561Medicaid
MO1184855561Medicaid
MO067820022Medicare PIN
MO1184855561Medicaid
MO430817642OtherTIN
MO016300015Medicare PIN