Provider Demographics
NPI:1871674234
Name:JOHN W MCGHAN DPM PC
Entity Type:Organization
Organization Name:JOHN W MCGHAN DPM PC
Other - Org Name:GOLD CANYON FOOT AND ANKLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:MCGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-982-8137
Mailing Address - Street 1:6499 S KINGS RANCH RD # 6-10
Mailing Address - Street 2:
Mailing Address - City:GOLD CANYON
Mailing Address - State:AZ
Mailing Address - Zip Code:85118-2902
Mailing Address - Country:US
Mailing Address - Phone:480-982-8137
Mailing Address - Fax:480-983-8153
Practice Address - Street 1:6820 S KINGS RANCH RD STE 130
Practice Address - Street 2:
Practice Address - City:GOLD CANYON
Practice Address - State:AZ
Practice Address - Zip Code:85118-2959
Practice Address - Country:US
Practice Address - Phone:480-982-8137
Practice Address - Fax:480-983-8153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZT41412Medicare UPIN
AZ118594Medicare PIN