Provider Demographics
NPI:1215036926
Name:MCMAHAN, JAMES D (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:MCMAHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4845 KNIGHTSBRIDGE BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-2463
Mailing Address - Country:US
Mailing Address - Phone:614-459-0060
Mailing Address - Fax:614-459-0110
Practice Address - Street 1:4845 KNIGHTSBRIDGE BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2463
Practice Address - Country:US
Practice Address - Phone:614-459-0060
Practice Address - Fax:614-459-0110
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH56789208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0801458Medicaid
OH0801458Medicaid
OHAD9284091Medicare ID - Type Unspecified