Provider Demographics
NPI:1104932177
Name:MCGEOUGH, JOHN FRANCIS (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANCIS
Last Name:MCGEOUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 HARPSWELL RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-7822
Mailing Address - Country:US
Mailing Address - Phone:207-725-4516
Mailing Address - Fax:
Practice Address - Street 1:85 BARIBEAU DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-3249
Practice Address - Country:US
Practice Address - Phone:207-729-8442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME008946208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MED03811Medicare UPIN
ME089681Medicare ID - Type Unspecified