Provider Demographics
NPI:1821232471
Name:JAMES F. MCNAB MD LLC
Entity Type:Organization
Organization Name:JAMES F. MCNAB MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:MCNAB
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:843-522-7800
Mailing Address - Street 1:PO BOX 864541
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-4541
Mailing Address - Country:US
Mailing Address - Phone:512-583-0205
Mailing Address - Fax:512-583-2002
Practice Address - Street 1:1680 RIBAUT RD
Practice Address - Street 2:STE A
Practice Address - City:PORT ROYAL
Practice Address - State:SC
Practice Address - Zip Code:29935-2008
Practice Address - Country:US
Practice Address - Phone:843-522-7800
Practice Address - Fax:843-524-0378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-27
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD293692085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC293694Medicaid
SC293694Medicaid