Provider Demographics
NPI:1790971802
Name:JOEL L MCGILL MD PSC
Entity Type:Organization
Organization Name:JOEL L MCGILL MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:MCGILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-358-3668
Mailing Address - Street 1:213 E CROSS STREET
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47220-2012
Mailing Address - Country:US
Mailing Address - Phone:812-358-3668
Mailing Address - Fax:812-358-3860
Practice Address - Street 1:213 E CROSS STREET
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN
Practice Address - State:IN
Practice Address - Zip Code:47220-2012
Practice Address - Country:US
Practice Address - Phone:812-358-3668
Practice Address - Fax:812-358-3860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2008-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
380770Medicare PIN