Provider Demographics
NPI:1942307897
Name:MCGINNIS, JOHN RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RICHARD
Last Name:MCGINNIS
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 1:764 W LIBERTY ST
Mailing Address - Street 2:ONE MEDICAL CT.
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4748
Mailing Address - Country:US
Mailing Address - Phone:803-778-2446
Mailing Address - Fax:803-773-7544
Practice Address - Street 1:764 W LIBERTY ST
Practice Address - Street 2:ONE MEDICAL CT.
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4748
Practice Address - Country:US
Practice Address - Phone:803-778-2446
Practice Address - Fax:803-773-7544
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1163111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH1163Medicaid
SCT240870281Medicare ID - Type Unspecified