Provider Demographics
NPI:1700120573
Name:MCMAHON, JEFFREY KARR (BA)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:KARR
Last Name:MCMAHON
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13307 BRIGHAM LN
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-6951
Mailing Address - Country:US
Mailing Address - Phone:815-370-8909
Mailing Address - Fax:727-547-6752
Practice Address - Street 1:13307 BRIGHAM LN
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-6951
Practice Address - Country:US
Practice Address - Phone:815-370-8909
Practice Address - Fax:727-547-6752
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker