Provider Demographics
NPI:1194850669
Name:ANGELA T MCGEE M D
Entity Type:Organization
Organization Name:ANGELA T MCGEE M D
Other - Org Name:BARNET PARK FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:THERION
Authorized Official - Middle Name:LANGFORD
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:864-542-9966
Mailing Address - Street 1:169 HALL ST
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-1523
Mailing Address - Country:US
Mailing Address - Phone:864-542-9966
Mailing Address - Fax:864-542-9977
Practice Address - Street 1:169 HALL ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-1523
Practice Address - Country:US
Practice Address - Phone:864-542-9966
Practice Address - Fax:864-542-9977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23635261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC236355Medicaid
SC236355Medicaid
SCAA02190281Medicare ID - Type Unspecified