Provider Demographics
NPI:1780656975
Name:MCGEHEE, DANIEL T (OD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:T
Last Name:MCGEHEE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 W CLARENDON AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3420
Mailing Address - Country:US
Mailing Address - Phone:808-346-3674
Mailing Address - Fax:480-924-5094
Practice Address - Street 1:300 W CLARENDON AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3420
Practice Address - Country:US
Practice Address - Phone:808-346-3674
Practice Address - Fax:480-924-5094
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ798152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZT36470Medicare UPIN
AZZ41WCLBB01Medicare PIN