Provider Demographics
NPI:1669464608
Name:MCMAHON, THOMAS ALLEN (DC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ALLEN
Last Name:MCMAHON
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 1:1400 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2901
Mailing Address - Country:US
Mailing Address - Phone:614-486-6755
Mailing Address - Fax:614-486-6781
Practice Address - Street 1:1400 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2901
Practice Address - Country:US
Practice Address - Phone:614-486-6755
Practice Address - Fax:614-486-6781
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH972111N00000X
FL4234111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4589899OtherAETNA
OH000000121069OtherANTHEM BCBS
OH44-00098OtherUNITED HEALTHCARE
T47744Medicare UPIN
OH0525771Medicare ID - Type Unspecified