Provider Demographics
NPI:1801903539
Name:MCNERNEY, JOSEPH PATRICK (DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:MCNERNEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:JOSEPH
Other - Middle Name:PATRICK
Other - Last Name:MCNERNEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:921 N CITRUS AVE
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34428-3422
Mailing Address - Country:US
Mailing Address - Phone:352-436-4328
Mailing Address - Fax:352-260-0960
Practice Address - Street 1:921 N CITRUS AVE
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34428-3422
Practice Address - Country:US
Practice Address - Phone:352-436-4328
Practice Address - Fax:352-260-0960
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7782207Q00000X
IA01879207Q00000X
MI1510106298207Q00000X
FLOS12491207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D46441Medicare UPIN