Provider Demographics
NPI:1376529800
Name:MCGEEHAN, CORNELIUS JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:CORNELIUS
Middle Name:JOSEPH
Last Name:MCGEEHAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4630 DARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34690-3906
Mailing Address - Country:US
Mailing Address - Phone:727-937-4223
Mailing Address - Fax:727-937-4224
Practice Address - Street 1:4630 DARLINGTON RD
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34690-3906
Practice Address - Country:US
Practice Address - Phone:727-937-4223
Practice Address - Fax:727-937-4224
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH001619111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T56286Medicare UPIN
FL89635Medicare ID - Type Unspecified