Provider Demographics
NPI:1669058988
Name:MCGIL, RONNELL LEVON
Entity type:Individual
Prefix:MR
First Name:RONNELL
Middle Name:LEVON
Last Name:MCGIL
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 1:170 SHAD BOAT LN
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-7323
Mailing Address - Country:US
Mailing Address - Phone:919-345-6882
Mailing Address - Fax:
Practice Address - Street 1:170 SHAD BOAT LN
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-7323
Practice Address - Country:US
Practice Address - Phone:919-345-6882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-18
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician