Provider Demographics
NPI:1245722156
Name:MCGUIRE, JOHN KENNETH
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:KENNETH
Last Name:MCGUIRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:EAST PALESTINE
Mailing Address - State:OH
Mailing Address - Zip Code:44413-0429
Mailing Address - Country:US
Mailing Address - Phone:330-426-9484
Mailing Address - Fax:330-426-2248
Practice Address - Street 1:28885 STATE ROUTE 62
Practice Address - Street 2:
Practice Address - City:DAMASCUS
Practice Address - State:OH
Practice Address - Zip Code:44619
Practice Address - Country:US
Practice Address - Phone:330-537-4661
Practice Address - Fax:330-537-4482
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCNP.022754363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily