Provider Demographics
NPI:1952668394
Name:MCGILTON, LILLIAN DARCY (DHAT)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:DARCY
Last Name:MCGILTON
Suffix:
Gender:F
Credentials:DHAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 BRENDIBLE ST
Mailing Address - Street 2:
Mailing Address - City:METLAKATLA
Mailing Address - State:AK
Mailing Address - Zip Code:99926
Mailing Address - Country:US
Mailing Address - Phone:907-886-6601
Mailing Address - Fax:
Practice Address - Street 1:563 BRENDIBLE ST
Practice Address - Street 2:
Practice Address - City:METLAKATLA
Practice Address - State:AK
Practice Address - Zip Code:99926
Practice Address - Country:US
Practice Address - Phone:907-886-6601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other