Provider Demographics
NPI:1649222852
Name:MAGILL, FRANK B JR (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:B
Last Name:MAGILL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:915 SHERIDAN ST
Mailing Address - Street 2:SUITE B103
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-2931
Mailing Address - Country:US
Mailing Address - Phone:360-385-4848
Mailing Address - Fax:360-379-4383
Practice Address - Street 1:915 SHERIDAN ST
Practice Address - Street 2:SUITE B103
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-2931
Practice Address - Country:US
Practice Address - Phone:360-385-4848
Practice Address - Fax:360-379-4383
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00038914207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB18480OtherMEDICARE RHC
WA8265696Medicaid
WA8265696Medicaid
WAAB18480OtherMEDICARE RHC