Provider Demographics
NPI:1932292802
Name:MCGILL, LEONARD JAMES (DC)
Entity Type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:JAMES
Last Name:MCGILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1291 FOLLY RD
Mailing Address - Street 2:M
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412
Mailing Address - Country:US
Mailing Address - Phone:843-795-5060
Mailing Address - Fax:843-795-4870
Practice Address - Street 1:1291 FOLLY RD
Practice Address - Street 2:M
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412
Practice Address - Country:US
Practice Address - Phone:843-795-5060
Practice Address - Fax:843-795-4870
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1503111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH1503Medicaid
SCCH1503Medicaid
U199180281Medicare ID - Type Unspecified