Provider Demographics
NPI:1528162054
Name:JOSEPH J MCGINNIS OD PA
Entity type:Organization
Organization Name:JOSEPH J MCGINNIS OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:MCGINNIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:208-777-0142
Mailing Address - Street 1:2017 S LIBERTY DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019
Mailing Address - Country:US
Mailing Address - Phone:509-255-9697
Mailing Address - Fax:
Practice Address - Street 1:3050 E MULLAN AVE
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854
Practice Address - Country:US
Practice Address - Phone:208-777-0142
Practice Address - Fax:208-777-0353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty