Provider Demographics
NPI:1821275967
Name:MCARDLE, JACQUELYN T (MD)
Entity Type:Individual
Prefix:DR
First Name:JACQUELYN
Middle Name:T
Last Name:MCARDLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 LONGVIEW DR.
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-8036
Mailing Address - Country:US
Mailing Address - Phone:717-334-8811
Mailing Address - Fax:717-334-8811
Practice Address - Street 1:80 LONGVIEW DR
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-8036
Practice Address - Country:US
Practice Address - Phone:717-334-8811
Practice Address - Fax:717-334-8811
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD006665E2084P0800X
PAMD06665E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry