Provider Demographics
NPI:1821036468
Name:MCGUKIN, DONALD R (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:R
Last Name:MCGUKIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:584 N GERMANTOWN PKWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-6240
Mailing Address - Country:US
Mailing Address - Phone:901-753-7686
Mailing Address - Fax:901-759-9968
Practice Address - Street 1:350 N HUMPHREYS BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2177
Practice Address - Country:US
Practice Address - Phone:901-227-0497
Practice Address - Fax:901-227-0499
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2007-11-29
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Provider Licenses
StateLicense IDTaxonomies
TN29738207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05083277Medicaid
TN3820523Medicaid
TN37243OtherTLC
TN3820523Medicare PIN
TN37243OtherTLC